Rhinoscleroma causing severe bilateral nasal obstruction

rhinoscleroma is a chronic, infectious and granulomatous disease of the respiratory tract. there is often a delay in diagnosis due to unfamiliarity with the disease and also because culture is not always positive. we report a case in a 26-year-old woman with granular mass obstructing bilateral nasal cavities and causing breathing difficulty. histopathological examination showed characteristic mikulicz histiocytes containing numerous gram-negative intracellular rod-shaped bacilli consistent with the diagnosis of rhinoscleroma. the patient was treated with gemifloxacin and tetracycline and remains asymptomatic over a year follow-up period. it is important to consider rhinoscleroma in cases of chronic nasal obstruction. as culture is not always positive, histopathological examination may be crucial to the diagnosis.