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Rhinoscleroma is a human specific chronic granulomatous infection of the nose and upper airways caused by the Gram-negative bacterium  Klebsiella pneumoniae  subsp.  rhinoscleromatis . Although considered a rare disease, it is endemic in low-income countries where hygienic conditions are poor. A hallmark of this pathology is the appearance of atypical foamy monocytes called Mikulicz cells. However, the pathogenesis of rhinoscleroma remains poorly investigated. Capsule polysaccharide (CPS) is a prominent virulence factor in bacteria. All  K .  rhinoscleromatis  strains are of K3 serotype, suggesting that CPS can be an important driver of rhinoscleroma disease. In this study, we describe the creation of the first mutant of  K .  rhinoscleromatis , inactivated in its capsule export machinery. Using a murine model recapitulating the formation of Mikulicz cells in lungs, we observed that a  K .  rhinoscleromatis  CPS mutant (KR  cps   -  ) is strongly attenuated and that mice infected with a high dose of KR  cps   -   are still able to induce Mikulicz cells formation, unlike a  K .  pneumoniae  capsule mutant, and to partially recapitulate the characteristic strong production of IL-10. Altogether, the results of this study show that CPS is a virulence factor of  K .  rhinoscleromatis  not involved in the specific appearance of Mikulicz cells.

Rhinoscleroma pathogenesis: The type K3 capsule of Klebsiella rhinoscleromatis is a virulence factor not involved in Mikulicz cells formation