A Rare Case Study of Atrophic Rhinitis Caused by Klebsiella ozaenae

Chronic atrophic rhinitis which is also known as empty nose syndrome or ozena is a chronic disease manifested with atrophy of the nasal mucosa, nasal crusting and foul-smelling discharge, and could progress to destruction of nasal bones, and anosmia. It is a rare disease especially seen in young women with low socio-economic level living in subtropical countries with poor hygienic conditions. In this study, a 9 year old male patient with chronic atrophic rhinitis caused by K. ozaenae is presented. Male patient admitted to the earnose- throat outpatient clinic with complaints of two years history of, nasal congestion, foul smelling discharge. Physical examination revealed yellowgreen crusts in nasal cavity, enlarged nasal cavity, postnasal drip, and atrophic turbinate and mucosa, nasal cultures taken from patient revealed K. ozaenae. Computer tomografie scan showed poor sinus development and ventilation. According to the results of the antibiotic sensitivity test 2x500 mg ceftriaxone treatment initiated, with twice daily nasal irrigation and moisturizing, The patients complaints disappeared three weeks later and anitibiotic treatment terminated. Continuation of nasal irrigation and moisturizing and regular follow up controls recommended after termination of antibiotic. In order to avoid delay of diagnosis; K. ozaenae induced atrophic rhinitis should be considered as a diagnosis in the presence of long lasting foul-smelling discharge, nasal congestion, and recurrent complaints despite long-term antibiotic therapy even in childhood.