ABSTRACT
Primary atrophic rhinitis is a chronic, progressive nasal disease accompanied by nasal cultures growing Klebsiella ozaenae. It occurs in elderly patients and is predomi nantly seen in less developed countries. This disease is characterized by nasal mucosal atrophy, resorption of underlying bone, and formation of thick nasal crusting with a charac teristic fetid odor. It can occur in previously healthy people or can be seen in those with previous nasal disruption because of nose and sinus surgery, tuberculosis, and syphilis. Symptoms of nasal congestion, constant bad smell (ozena), and headache are present. Sinusitis is a frequent complication. While the etiology of primary atrophic rhinitis is considered to be infectious, the presence of organisms may represent contamination of a previously damaged mucosa. In addition K. ozaenae produces a ciliostatic effect by creat ing intraciliary adherence that leads to poor mucociliary clearance. Antibiotic therapy is usually successful in controlling the rhinitis and accompanying sinusitis.
