General Medical Information

Granulomatous Disease

Richard L. Mabry

Rhinitis and nasal obstruction can be caused by granulomatous disease of the nose and paranasal sinuses. Mass lesions can cause nasal obstruction through direct occlusion of the nasal cavity or through an intranasal inflammatory reaction that produces viscous secretions, crusting, and nasal passage occlusion. In the United States, the most common granulomas include polymorphic reticulosis, nonhealing lethal midline granuloma, Wegener granulomatosis, rhinoscleroma, sarcoidosis, and tuberculosis. Nasal obstruction can be caused by additional granulomatous infections such as blastomycosis, coccidioidomycosis, histoplasmosis, leprosy, sporotrichosis, and syphilis; however, these infectious processes are rare in the United States. Efficacious management of these conditions is direct medical control of the pathogenic organism.