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免疫抑制患者鼻中隔脓肿:病例报告

Nasal septal abscess in patient with immunosuppression: Case report.

作者信息

El Azzouzi Rajaa, Boukhlouf Oumaima, Dani Bouchra, Boulaadas Malik

机构信息

Department 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.

Department 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.

出版信息

Int J Surg Case Rep. 2025 Aug 18;135:111838. doi: 10.1016/j.ijscr.2025.111838.

Abstract

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.

摘要

引言

鼻中隔脓肿是一种鼻科急症,其特征是在鼻中隔支架与其黏膜软骨膜/黏膜骨膜覆盖层之间有脓性积聚。虽然最常见于创伤后血肿处理不当继发感染。尽管鼻中隔成形术是一种清洁-污染手术,但术后发病率仍低于1%,这归因于该区域丰富的血管化。

病例介绍

一名40岁2型糖尿病控制不佳的女性,在鼻中隔成形术后四周出现双侧鼻塞和鼻中隔疼痛。增强计算机断层扫描(CT)成像确诊为鼻中隔脓肿,需紧急入住我院耳鼻喉科。

临床讨论

广谱抗生素的出现和医疗条件的改善显著降低了这种疾病的发病率。然而,潜在并发症仍然严重,包括颅内扩展(脑膜炎、脑脓肿)、败血症和海绵窦血栓形成。免疫功能低下的患者对疾病进展特别易感。

结论

这种病理状况具有重大的功能影响和危及生命的后果,凸显了及时诊断和立即进行治疗干预的至关重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dea/12396482/f1407058f413/gr1.jpg

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