Chronic nasal infection caused by Klebsiella rhinoscleromatis or Klebsiella ozaenae: two forgotten infectious diseases.

OBJECTIVES: Klebsiella rhinoscleromatis and Klebsiella ozaenae are associated with chronic diseases of the upper airways: rhinoscleroma and ozena, respectively. These have become uncommon in developed countries. We report herein one case of each disease in patients living in Marseilles, France, and include a review of the literature.

METHODS: Diagnosis was made by direct evidence of bacteria (specific cultures and autoimmunohistochemistry on nasal biopsy) and using an indirect method (serology). In addition, the literature review showed that the majority of publications were old, confirming the fact that these diseases have been long forgotten.

RESULTS: The specific and original methods used have allowed us to confirm the pathogenic role of K. ozaenae in ozena and confirmed rhinoscleroma in a granulomatous lesion. In the literature, K. rhinoscleromatis is only associated with rhinoscleroma whereas K. ozaenae is also associated with clinical diseases other than chronic rhinitis.

CONCLUSIONS: In cases of chronic rhinitis, ozena and rhinoscleroma should be kept in mind, even in developed countries, and systematically screened for, especially as there are specific diagnostic tools and effective treatments available.