Midline Destructive Lesion has various etiologies including malignancy, infection, autoimmune, traumatic or unknown process. Lactose fermenter Klebsiella pneumonia causing MDL of the nose is extremely rare. We present here a case of 48 year-man with MDL of the nose with disseminated Klebsiella pneumonia, who initially presented with an innocent small pimple. This case had posed a diagnostic conundrum to the otolaryngologists involved. To the best of our knowledge, this is the only report of MDL caused by Klebsiella pneumoniae infection occurring in the skin and soft tissue of the nose in the English literature.
Key words: Granuloma, lethal midline, histiocytes, Klebsiella infections, rhinoscleroma.
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