A 30-year-old woman presents with foul-smelling greenish nasal crusts, anosmia, and a sensation of nasal obstruction despite widely patent nasal cavities on endoscopy. Culture of the crusts most commonly yields which organism?
- A Klebsiella pneumoniae subsp. ozaenae ✓
- B Pseudomonas aeruginosa
- C Staphylococcus aureus
- D Haemophilus influenzae
Correct answer: A. Klebsiella pneumoniae subsp. ozaenae
Explanation
Atrophic rhinitis (ozaena) is characteristically colonised by Klebsiella pneumoniae subsp. ozaenae, formerly called Klebsiella ozaenae, along with diphtheroids and Proteus. The organism contributes to the foul odour by acting on the crusts. Staphylococcus aureus is the usual coloniser in rhinitis sicca and postoperative crusting, not classic ozaena, so it is the tempting distractor here.
Reference: Scott-Brown's Essential Otorhinolaryngology, 2nd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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