Endoscopy of the Air Passages with Special Reference to Scleroma

Abstract

Peroral endoscopy has contributed to other medical specialties such as anesthesia and thoracic surgery. Scleroma is a chronic infection of the respiratory tract prevalent in the tropics of the American continent. Two hundred and thirty-two patients suffering from scleroma were seen at the Department of Otolaryngology of the General Hospital of Mexico City. The first symptoms may appear within the first decade of life, being seen a little more frequently in females than in males. The etiologic agent is considered to be the Klebsiella rhinoscleromatis. Onset is in the nose, resembling a common cold. The larynx is involved in 15% of the patients and the bronchi in 2%. Clinically, all phases of scleroma may suffer spontaneous changes. Atrophy of the mucosa may be confused with other diseases such as ozena or leprosy. Treatment includes the administration of antibiotics having specific action against the germ and tracheostomy in dyspneic patients. Direct laryngoscopy and bronchoscopy are indicated in many of the patients. Laryngostomy or even lobectomy has been performed in our series. Cure is possible in older patients who have been treated for many years.