Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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January 25, 2016
Nasal Septal Abscess
- Background:
- Nasal septal abscesses are uncommon, most frequently caused by recent nasal surgery, trauma, nasal furuncles, or chronic dental infections.1
- Clinical Presentation:
- Subtle, symmetric, linear fluid collections may often be overlooked if clinical history is not known during time of reporting.
- It is important to assess for underlying/pre-existing lesions (such as a dermoid or epidermoid), which are known to be associated with abscess formation, especially in neonates.2
- Complications may involve severe functional and/or cosmetic nasal-septal damage, or potentially brain abscess formation.3
- Key Diagnostic Features:
- Enhanced CT is a preferred modality in making an early diagnosis.
- Differential Diagnosis (Broad):
- Infectious: Typical infections (S. aureus, S. pneumonia), atypical (tuberculosis, fungal)
- Neoplastic: Lymphoma, metastasis, nasal glioma, esthesioneuroblastoma, sarcoma, chloroma
- Inflammatory: Wegener granulomatosis
- Treatment:
- Adequate surgical drainage, broad-spectrum antibiotics
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