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)