Daza HAL, Arroyo ES, Bravo EGA

Language: Spanish
References: 9
Page: 1-10
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ABSTRACT

Background: Chronic rhinitis, characterized by irritation and persistent inflammation of the nasal mucosa, is caused generally by Staphylococcus aureus and Klebsiella. Citrobacter koseri is an opportunistic bacterium, not recognized as a pathogen of the respiratory tract and not reported previously as cause of disease in otolaringology, mainly it has been reported as cause of meningitis in neonates and immunocompromised patients as a severe acute infection; it has been described that in other anatomical sites destroys the microvilli.
Objective: To know the cause of chronic rhinitis and to identify possible new cases.
Material and method: A descriptive, retrospective, longitudinal, analytic study was performed with 25 records of patients attended at the Service from September 2011 to March 2012 with chronic nasal inflammatory manifestations without response to conventional therapy, in whom cultures of nasal secretion by means of endoscopy, computed tomography of nose and paranasal sinuses, laboratory samples including cANCAS, and biopsy with histopathologic study and stains (Warthin-Starry and Zielh-Neelsen) were done, looking for identifying the etiology of inflammatory processes and to discard diseases that could jeopardize the immunity of the individuals.
Results: In addition to the known germs producing chronic rhinitis, in the cultures of the 25 studied cases, 4 cases of Citrobacter koseri were identified, in isolated form in one and as a copathogen in 3, presenting as indolent nasal chronic infection in immunocompetent patients.
Conclusions: Citrobacter koseri must be included among the differential diagnosis of chronic rhinitis, being differentiated from other diseases such as rhinoscleroma, tuberculosis and Wegener granulomatosis.

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