Lepromatous Rhinitis an Unusual Presentation of
Hansen’s Disease:
Case Report:
Thong HK, MD, MS Otolaryngology (ongoing)¹,
Aminuddin BS, MD, MS Otolaryngology, Fellowship in Pediatric ENT²
Affiliation : ¹ Department of Otorhinolaryngology-Head & Neck Surgery, KPJ Healthcare University College, Nilai, Negeri Sembilan, Malaysia ² Ear, Nose & Throat-Head & Neck Consultant Clinic, KPJ Ampang Puteri Specialist Hospital /KPJ Healthcare University College, Malaysia
Background: Leprosy (Hansen’s disease) is a chronic granulomatous infection caused by the bacteria Mycobacterium leprae .
Classically leprosy affects the skin and peripheral nerves. The paranasal sinuses can also be infected and can serve as reservoirs
for the reactivation of disease.
Case Report: A 31-year-old male patient, a private banker, presented to the authors ENT outpatient clinic with complaints of nasal obstruction, foul-smelling nasal discharge (ozaena), and intermittent epistaxis for the past one month, associated with multiple cutaneous nodules over the bilateral ear pinnae. Biopsy of the nasal mucosa revealed chronic granulomatous inflammation with multinucleated giant cells surrounded by abundant bacilli consistent with histoid leprosy.
Conclusion: Leprosy remains a major public health hazard as new cases are still being reported. The otolaryngologist should remain vigilant and have high index of suspicion for leprosy in patients with chronic nasal symptoms to prevent the potential morbidities that accompany this disease.
Keywords : Leprosy, Lepromatous rhinitis, Atrophic rhinitis, Mycobacterium leprae , Chronic rhinosinusitis
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