Progressive anosmia revealing olfactory cleft actinomycosis: A CARE case report

Progressive anosmia, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for nasal polyps. In the absence of polyposis, radiological work-up should diagnose and treat any curable pathology. Here, we report the case of a patient treated for olfactory cleft actinomycosis.

A 72 year-old man, without relevant medical history, was referred for progressive hyposmia and unilateral greenish rhinorrhea resistant to well-conducted medical treatment. Nasal endoscopy and imaging suggested a fungus ball in the left olfactory cleft. Endoscopic surgery fully restored olfaction, with histologic confirmation of actinomycetes.

The present case highlights the importance of prompt diagnosis in progressive anosmia, and demonstrates the efficacy of exclusively surgical management.