Laryngotracheobronchial involvement in a patient with nonendemic rhinoscleroma

We report the first ease of rhinoscleroma in an Israeli citizen, a former s ailor with a transatlantic shipping company. Characteristic histologic chan ges from a tracheal biopsy and isolation of Klebsiella rhinoscleromatis fro m a blood culture after diagnostic bronchoscopy confirmed the diagnosis. Ex treme delay in the diagnosis, a not uncommon feature in nonendemic areas, w as associated with severe advanced laryngotracheobronchial disease. Treatme nt with quinolones was followed by significant improvement, but the patient died 1 month after presentation, apparently from upper airway obstruction.