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Nasal septal abscess in patient with immunosuppression: Case report
Rajaa El Azzouzi1, Oumaima Boukhlouf1, Bouchra Dani1
1Department of Maxillofacial Surgery Hospital of Specialities, CHU Ibn Sina, Av. Abderrahim Bouabid, Rabat, Morocco; Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Imp. Souissi, 10100 Rabat, Morocco.
Introduction:
Nasal septal abscess constitutes a rhinologic emergency, characterized by purulent accumulation between the septal framework and its mucoperichondrial/mucoperiosteal covering. While most frequently arising from secondary infection of inadequately managed post-traumatic hematomas. Despite rhinoseptoplasty being a clean-contaminated procedure, postoperative incidence remains below 1 %, attributable to the region's robust vascularization.
Case Presentation:
A 40-year-old female with poorly controlled type 2 diabetes mellitus presented four weeks post-rhinoseptoplasty with bilateral nasal obstruction and septal pain. Contrast-enhanced computed tomography CT scan imaging confirmed the diagnosis of nasal septal abscess, necessitating urgent hospitalization in our otolaryngology department.
Clinical Discussion:
The advent of broad-spectrum antibiotics and improved healthcare access has significantly reduced the incidence of this condition. However, potential complications remain severe, including intracranial extension (meningitis, cerebral abscess), septicemia, and cavernous sinus thrombosis. Immunocompromised patients demonstrate particular vulnerability to disease progression.
Conclusion:
This pathology carries significant functional and life-threatening implications, underscoring the critical importance of prompt diagnosis and immediate therapeutic intervention.
Insights
Nasal septal abscess is a serious condition requiring immediate treatment. Prompt diagnosis and intervention are crucial to prevent severe complications like meningitis and sepsis.
Area of Science:
- Otolaryngology
- Rhinology
Background:
- Nasal septal abscess is a rare but serious complication, often stemming from untreated septal hematomas.
- While rhinoseptoplasty has a low incidence (below 1%), it can occur post-operatively.
Observation:
- A 40-year-old female with type 2 diabetes presented with nasal obstruction and pain four weeks after rhinoseptoplasty.
- Computed tomography (CT) confirmed a nasal septal abscess, requiring urgent hospitalization.
Findings:
- Nasal septal abscesses are medical emergencies requiring prompt diagnosis and treatment.
- Potential complications include intracranial extension, septicemia, and cavernous sinus thrombosis, especially in immunocompromised individuals.
Implications:
- Early recognition and intervention are vital to prevent severe, life-threatening complications.
- This case highlights the importance of vigilance for nasal septal abscesses, particularly in diabetic patients post-surgery.
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