RHINOSCLEROMA TREATED WITH CIPROFLOXACIN - A CASE-REPORT

Rhinoscleroma, a chronic progressive infection of the nose and associa ted structures caused by Klebsiella rhinoscleromatis, has posed a ther apeutic dilemma since its identification in the late 1800s. Although a number of antibiotics have been found to be effective in this relapsi ng disorder,(1-6) the lengthy duration of treatment can lead to proble ms with adverse effects and compliance, especially with the traditiona l therapies of streptomycin and tetracycline. We report on a patient w ith extensive nasal rhinoscleroma who achieved pathologic and bacterio logic resolution during treatment with oral ciprofloxacin after previo us courses of tetracycline and trimethoprim-sulfamethoxazole. Ciproflo xacin may prove to be useful in the therapy of rhinoscleroma because h is convenient for oral administration, achieves good tissue levels, is concentrated in macrophages,(7) and is generally well tolerated as lo ng-term therapy. As mentioned in a recent review of patients with rhin oscleroma at the Mayo Clinic, the fluoroquinolones deserve further stu dy as potentially highly effective agents for this uncommon but signif icant infectious condition.(8)