Rhinoscleroma and chronic rhinosinusitis—an insidious presentation

Background: Rhinoscleroma is a chronic granulomatous infectious disease of the respiratory mucosa, endemic in some countries of Central America, Southeast Asia, and parts of Africa, but rare in North America. Methods: We report the case of a 35-year-old man who immigrated to Canada from El Salvador at 10 years of age who was diagnosed with rhinoscleroma 25 years after his immigration. Results: He presented with chronic rhinosinusitis (CRS), rhinorrhea, and nasal congestion for 14 years that did not respond to standard CRS treatment. His symptoms resolved with the administration of appropriate antibiotic therapy following the diagnosis of rhinoscleroma based on histopathological examination and nasal culture. Conclusion: This case report highlights the importance of recognizing non-endemic diseases in the era of mass global migration. Clinicians should consider epidemiology and non-endemic infections when evaluating patients with CRS and refer those who are refractory to standard therapy to an otolaryngologist for further assessment.