{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:44:15Z","timestamp":1760985855252,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2018\/24715\u20102"],"award-info":[{"award-number":["2018\/24715\u20102"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate clinical and pathologically cases of respiratory scleroma diagnosed in a 30\u2010year period in Guatemala.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Fifty\u2010one cases of respiratory scleroma diagnosed from 1988 to 2018 in a single pathology service in Guatemala were confirmed using Warthin\u2013Starry staining. Immunohistochemical reactions against CD68, LCA, CD20, CD3, and CD138 were performed to illustrate the inflammatory infiltrate. Scanning electron microscopy (<jats:italic>SEM<\/jats:italic>) was performed to illustrate bacteria morphology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 51 cases affected patients from poor areas of Guatemala, particularly women (66.7%), with a mean age of 31\u00a0years (range 7\u201366\u00a0years). Nose was affected in most cases (96.1%). Other sites involved included pharynx, larynx, palate, maxillary sinuses, and upper lip. Depending on the stage, the disease manifested as ulcerations, nasal deformities, or laryngeal stenosis. Nasal obstruction, epistaxis, dysphonia, fetid discharge, and pain were the main symptoms. Mikulicz cells (CD68+) in a plasma cell\u2010rich inflammatory background (CD138+, CD20+, CD3+\/\u2212) were the typical microscopic presentation. In <jats:italic>SEM<\/jats:italic>, each macrophagic vacuole contained few to dozens of <jats:italic>Klebsiella rhinoscleromatis<\/jats:italic> diplobacilli. Treatment consisted of long\u2010term trimethoprim and sulfamethoxazole, with adequate control of disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Respiratory scleroma is a rare infectious disease affecting the upper respiratory tract, in poor regions of the world, including Guatemala.<\/jats:p><\/jats:sec>","DOI":"10.1111\/odi.13264","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T17:36:41Z","timestamp":1577122601000},"page":"670-676","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Respiratory scleroma: A clinicopathologic study of 51 cases from Guatemala"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8036-0705","authenticated-orcid":false,"given":"Bruno A. L. 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