A 28-year-old woman from Bihar presents with progressive nasal obstruction, blood-streaked discharge, and a firm, nodular granular mass extending from the nose into the nasopharynx. Biopsy shows large pale vacuolated histiocytes with round inclusion-like bodies, plasma cells, and Russell bodies. Which causative organism and cell are characteristic of this disease?
- A Mycobacterium tuberculosis, Langhans giant cells
- B Rhinosporidium seeberi, sporangia containing endospores
- C Klebsiella pneumoniae subsp rhinoscleromatis, Mikulicz cells ✓
- D Leishmania donovani, Leishman-Donovan bodies
Correct answer: C. Klebsiella pneumoniae subsp rhinoscleromatis, Mikulicz cells
Explanation
This is rhinoscleroma, a chronic granulomatous disease caused by Klebsiella pneumoniae subsp rhinoscleromatis, endemic in parts of eastern India and Africa. Mikulicz cells are large foamy vacuolated histiocytes containing the bacilli, and Russell bodies from plasma cells complete the histology. Rhinosporidiosis shows thick-walled sporangia, tuberculosis shows caseating granulomas, and leishmaniasis shows intracellular amastigotes rather than Mikulicz cells.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.