{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T05:23:21Z","timestamp":1787289801897,"version":"build-2736575974"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Rhinoscleroma is a chronic granulomatous infection of the upper airway traditionally considered a monomicrobial disease caused by\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      subsp.\n                      <jats:italic>rhinoscleromatis<\/jats:italic>\n                      . However, limited use of deep-tissue microbiological sampling may have contributed to underrecognition of additional bacterial isolates and microbial complexity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a biopsy-confirmed case of nasal rhinoscleroma in a previously healthy adult. Histopathological evaluation and microbiological analysis were performed on deep intranasal tissue. Bacterial identification was conducted using VITEK 2 and MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was interpreted according to EUCAST 2025 criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Histology demonstrated characteristic Mikulicz cells. Microbiological analysis revealed\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      (consistent with subsp.\n                      <jats:italic>rhinoscleromatis<\/jats:italic>\n                      ) together with\n                      <jats:italic>Morganella morganii<\/jats:italic>\n                      from deep-tissue biopsy. Importantly, both organisms were also recovered from an independent nasal swab specimen, with concordant antimicrobial susceptibility profiles.\n                      <jats:italic>M. morganii<\/jats:italic>\n                      showed resistance to aminopenicillins and amoxicillin\u2013clavulanate while remaining susceptible to piperacillin\u2013tazobactam, consistent with its intrinsic AmpC \u03b2-lactamase profile. Microbiological findings prompted targeted modification of antimicrobial therapy, and targeted therapy with oral levofloxacin was initiated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests possible microbial complexity in rhinoscleroma and highlights the value of deep-tissue and concordant multi-sample microbiological evaluation. Recognition of co-isolated organisms may have implications for antimicrobial selection and stewardship, although their pathogenic contribution requires further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1837785","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:23:19Z","timestamp":1787286199000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Revisiting rhinoscleroma microbiology: a case with concordant dual-specimen bacterial isolation"],"prefix":"10.3389","volume":"16","author":[{"given":"Lorenzo","family":"Drago","sequence":"first","affiliation":[{"name":"Unit\u00e0 Operativa Complessa (UOC) Laboratory of Clinical Medicine with Specialized Areas, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica","place":["Milan, Italy"]},{"name":"Department of Biomedical Health Sciences, University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Papanikolau","sequence":"additional","affiliation":[{"name":"Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Preti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Mozzanica","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica","place":["Milan, Italy"]},{"name":"Department of Clinical Sciences and Community Health, University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Regenburgh","family":"De La Motte","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa (UOC) Laboratory of Clinical Medicine with Specialized Areas, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Pelosi","sequence":"additional","affiliation":[{"name":"Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica","place":["Milan, Italy"]},{"name":"Department of Oncology and Hemato-Oncology, University of Milan","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Deflorio","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa (UOC) Laboratory of Clinical Medicine with Specialized Areas, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151ra124","DOI":"10.1126\/scitranslmed.3003783","article-title":"Sinus microbiome diversity depletion and Corynebacterium tuberculostearicum enrichment mediates rhinosinusitis","volume":"4","author":"Abreu","year":"2012","journal-title":"Sci. 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