Infections: bacterial, viral, fungal, parasitic: rhinoscleroma: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Infections: bacterial, viral, fungal, parasitic: rhinoscleroma

Sample item

A 32-year-old from a rural area has progressive nasal obstruction with a hard, painless, woody infiltrate of the nasal tip and upper lip. Biopsy shows large foamy macrophages containing Gram-negative rods and plasma cells with Russell bodies. Which organism is responsible?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Klebsiella rhinoscleromatis

Rhinoscleroma is a chronic granulomatous disease of the nose caused by Klebsiella rhinoscleromatis. Foamy macrophages called Mikulicz cells and Russell bodies are the histological clues, and treatment is a prolonged course of antibiotics such as ciprofloxacin.

Option by option

  • A. Mycobacterium leprae

    M. leprae appears as acid-fast bacilli, not Gram-negative rods, and involves nerves along with skin.

  • B. Leishmania donovani

    Leishmania gives intracellular amastigotes with kinetoplasts in macrophages, not Gram-negative rods.

  • C. Klebsiella rhinoscleromatis (correct)

    Correct. Mikulicz cells with Gram-negative bacilli identify Klebsiella rhinoscleromatis.

  • D. Rhinosporidium seeberi

    Rhinosporidium forms large sporangia with endospores and gives a friable, bleeding polyp rather than a hard infiltrate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, Klebsiella rhinoscleromatis. Rhinoscleroma is a chronic granulomatous disease of the nose caused by Klebsiella rhinoscleromatis.

Why is "Mycobacterium leprae" not the answer?

M. leprae appears as acid-fast bacilli, not Gram-negative rods, and involves nerves along with skin.

Why is "Leishmania donovani" not the answer?

Leishmania gives intracellular amastigotes with kinetoplasts in macrophages, not Gram-negative rods.

Why is "Rhinosporidium seeberi" not the answer?

Rhinosporidium forms large sporangia with endospores and gives a friable, bleeding polyp rather than a hard infiltrate.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: rhinoscleroma in Dermatology. Foamy macrophages called Mikulicz cells and Russell bodies are the histological clues, and treatment is a prolonged course of antibiotics such as ciprofloxacin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infections: bacterial, viral, fungal, parasitic: rhinoscleroma?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.