MRSA Nasal Abscess after Elective Septorhinoplasty

Abstract

Objective: Present a case of an MRSA nasal abscess after elective septorhinoplasty. Discuss the role for MRSA screening and decolonization prior to elective septorhinoplasty. Method: The case of a patient who underwent elective septorhinoplasty complicated by a nasal abscess is reviewed. Current literature regarding MRSA surgical site infections and role for preoperative decolonization are discussed. Results: A 33-year-old man with nasal airway obstruction underwent functional septorhinoplasty. Mupirocin coated intranasal splints were placed, and he received 7 days of oral cephalexin. Six days postoperatively he presented with a nasoseptal abscess. He was taken to the OR for washout. Six months postoperatively he underwent revision septorhinoplasty. He was treated preoperatively with intranasal mupirocin and chlorhexidine body washes for 2 weeks. He experienced no further infectious complications. Despite MRSA being a well-documented cause of surgical infections, there are few reports of such infections in septorhinoplasty. There are no guidelines regarding the role of MRSA screening and decolonization before septorhinoplasty. Conclusion: Despite the well-documented role of MRSA in surgical site infections in other specialties, such infections following septorhinoplasty are extremely rare with only one previously published case. We present a case of a nasoseptal abscess causing significant morbidity following elective functional septorhinoplasty. This case highlights the need for research and guidelines regarding the utility of MRSA screening and decolonization prior to elective septorhinoplasty.