Nasal septal abscess: an unusual complication of acute spheno-ethmoiditis

Abstract

Nasal septal abscess complicating acute sinusitis is rare. There have been very few reports in the literature of this condition. We present a 12-year old-male with a nasal septal abscess complicating acute pansinusitis.

Nasal Septal Abscess in Patients with Immunosuppression

“…The imaging findings of nasal septal abscess, a thin-walled fluid collection with adjacent inflammatory change, are similar to those seen with abscesses located elsewhere within the body. Pang et al 3 reported a case of nasal septal abscess as an unusual complication of acute spheno-ethmoiditis with similar imaging findings of a thin-walled, enhancing fluid collection involving the cartilaginous and bony septum.…”

“…2 Surgical drainage of the purulent contents of a nasal septal abscess is performed to relieve pressure and to provide a specimen for Gram stain, culture, and sensitivity. Nasal packing, the placement of a Penrose drain, 3 reduction of nasal fractures, and delayed reconstruction of destroyed nasal cartilage 2 may also be performed. The results of Gram stain and culture and sensitivity of the aspirate determine the appropriate systemic antibiotic coverage.…”

“…1,5 Other organisms include Streptococcus pneumoniae or Streptococcus viridans, Staphylococcus epidermidis, and Haemophilus influenzae. 3,6 Early diagnosis and treatment are essential to prevent associated complications of the nasal septal abscess. These include sepsis, bacteremia, meningitis, brain abscess, cavernous sinus thrombosis, and maxillary hypoplasia.…”

“…These include sepsis, bacteremia, meningitis, brain abscess, cavernous sinus thrombosis, and maxillary hypoplasia. 3,7,8 Destruction of cartilage may cause a depression of the nasal bridge from collapse of structural support leading to the formation of a saddle nose deformity. 2,3,6 It should also be remembered that granulocytic sarcoma can both mimic and coexist with infection.…”

“…1 Nasal septal abscesses occur more commonly after minor nasal trauma 1 but may also result from iatrogenic causes 2 and sinonasal 3 or dental infection. 4 After minor nasal trauma, a hematoma may form secondary to the rupture of small blood vessels in the nasal septum.…”