“…Toxoplasmosis can readily be distinguished from SHML by serological tests but false positive values in the toxoplasma haemagglutination inhibition test have been recorded in SHML (Woodcock and Hart, 1980) and the toxoplasma dye test is recommended. Because of the possible association of SHML with rhinoscleroma (Edwards, Roberts and Storrs, 1977) or with elevated antibody titres to Klebsiella antigens which include those of K. rhinoscleromatis (Lampert and Lennert, 1976), we investigated the patient for signs of rhinoscleroma but could find none. However, there may be an underlying similarity in pathogenesis between SHML and diseases such as rhinoscleroma and lepromatous leprosy which, as an aberration of immune or allergic response, form histiocytic granulomas.…”