CHAPTER IX. 

 RHINOSCLEROMA. 



BACILLUS RmNOScivEROMATis (VON FRISCH*). 



General Characteristics. A non-motile, non-flagellate, non- 

 sporogenous, non-chromogenic, aerobic and optionally anaerobic, cap- 

 sulated bacillus, pathogenic for man and identical with Bacillus pneu- 

 monise of Friedlander, except that it stains by Gram's method. 



A peculiar disease of the nares, characterized by the 

 formation of circumscribed nodular tumors, and known 

 as rhinoscleroma, is occasionally seen in Austria-Hungary, 

 Italy, and some parts of Germany. A few cases have been 

 observed among the foreign-born residents of the United 

 States. The nodular masses are flattened, may be discrete, 

 isolated, or coalescent, grow with great slowness, and recur 

 if excised. The disease commences in the mucous mem- 

 brane and the adjoining skin of the nose, and spreads to the 

 skin in the immediate neighborhood by a slow invasion, 

 involving the upper lip, jaw, hard palate, and sometimes 

 even the pharynx. The growths are without evidences of 

 acute inflammation, do not ulcerate, and upon microscopic 

 examination consist of an infiltration of the papillary layer 

 and corium of the skin, with round cells which in part change 

 to fibrillar tissue. The tumors possess a well-developed 

 lymph-vascular system. Sometimes the cells undergo hya- 

 line degeneration. 



In the nodes von Frisch discovered bacilli closely re- 

 sembling the pneumobacillus of Friedlander, both in mor- 

 phology and vegetation, and, like it, surrounded by a 

 capsule. The only differences between the bacillus of 

 rhinoscleroma and Bacillus pneumonias of Friedlander are 

 that the former stains well by Gram's method, while the 

 latter does not; that the former is rather more distinctly 

 rod-shaped than the latter, and more often shows its capsule 

 in culture media. 



The bacillus can be cultivated, and cultures in all media 



* "Wiener med. Wochenschrift," 1882, 32. . 

 448 



