Infections of the Ears, Nose, Throat, and Sinuses by Marlene L. Durand & Daniel G. Deschler

Author:Marlene L. Durand & Daniel G. Deschler
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Nasal manifestations of leprosy occur in lepromatous leprosy , and nasal discharge in lepromatous disease contains abundant M. leprae. Intranasal findings may be the only manifestations of early lepromatous leprosy. Barton and Davey’s 1976 description of intranasal findings in 300 leprosy patients remains helpful [35]. In this series, intranasal infection was not seen in patients with tuberculoid leprosy, but was seen in 97% of patients with lepromatous leprosy. These patients usually complained of nasal congestion, crusting, and bleeding; 40% had hyposmia. Early findings included nodular thickening of the nasal mucosa, which often appeared paler than surrounding tissues, or isolated mucosal nodules. The anterior end of the inferior turbinate was the site involved first. Patients with later stage lepromatous leprosy had “gross inflammation of the nasal mucosa and severe obstruction” [35], and some also had perforation of the septal cartilage. With progressive untreated infection, perichondritis and periosteitis of the septum and inferior turbinates develops and leads to the classic saddle nose deformity (Fig. 16.6c). A very rare nasal manifestation of lepromatous leprosy is an intranasal mass, or leproma. This was described recently in a Korean patient who had no other apparent signs of leprosy [36].

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