Nasal Septal Abscess (NSA) is a rare but serious condition that typically arises from trauma, infections, or surgical interventions. However, in immunocompromised patients, NSA may develop spontaneously due to underlying haematological conditions. A 28- year-old male with recently diagnosed pre-B-cell Acute Lymphoblastic Leukaemia (ALL) presented with bilateral nasal obstruction and respiratory discomfort. Examination and imaging confirmed an NSA with cartilage erosion. Initial management included aspiration and empirical antibiotic therapy. However, recurrence necessitated incision and drainage, with cultures revealing fungal elements, prompting antifungal treatment. The patient responded well to therapy and no long-term complications were observed. This case underscores the importance of recognising NSA as a potential complication in leukaemia patients, even in the absence of trauma. Timely diagnosis and appropriate management are critical in preventing complications such as nasal deformities and recurrent infections.

Spontaneous nasal septal abscess is a rare condition. It typically occurs following traumatic events preceded by septal hematoma. Prompt recognition and intervention are must to avoid further infective and cosmetic complications. Hence, it is considered as a rhinologic emergency. This is a case of 27 years female with complaints of nasal mass, swelling , pain and difficulty in breathing for 7 days. She was diagnosed as spontaneous nasoseptal abscess and surgical intervention made her symptoms free.

This case report highlights a rare instance of a nasal septal abscess in a 16-year-old epileptic patient following unrecognized post-seizure trauma. The patient presented with nasal obstruction, facial pain, and fever. Diagnosis was confirmed by endoscopic examination and aspiration of purulent material, with Streptococcus pneumoniae identified on culture. Prompt surgical drainage under local anesthesia and empirical antibiotic therapy, later adjusted based on culture results, led to full recovery within ten days, without nasal deformity.This case report aims to highlight the diagnostic and therapeutic challenges of nasal septal abscess in a pediatric patient with epilepsy and emphasize the importance of early intervention.The case emphasizes the need for early detection and management of nasal septal bscesses, especially in patients at risk for unnoticed trauma.

Late-Onset Nasal Septal Abscess Formation Secondary to Bipolar Electrocoagulation for Anterior Epistaxis: An Overlooked Risk in Routine Clinical Practice.

There is limited evidence on the optimal management of nasal septal haematoma and abscess. This systemic review aims to summarise the management and outcomes and identify gaps in the literature. A systematic search of Embase, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) and CINAHL was done. We included all studies on management of paediatric and adult patients with nasal septal haematoma or nasal septal abscess. Seventeen articles were included (15 retrospective and 2 prospective) totalling 503 patients. Prophylactic antibiotics generally are used in nasal septal haematoma. Most septal collections were drained under general anaesthetic, and incision and drainage used in all. Quilting sutures, drains, nasal packing or a combination of these surgical techniques were described. Re-collection occurred in 18 of the 503 (3.6 per cent) patients. Low rates of re-collection following incision and drainage are reported. There is a lack of well-designed studies that stratify outcomes and morbidity of nasal septal abscess and nasal septal haematoma based on mode of treatment.

Abstract Spontaneous nasal septal abscess (NSA) is a relatively uncommon medical condition associated with a heightened risk of severe complications and unfavorable outcomes. Despite only a limited number of the reported cases involving immunocompetent individuals, we present a unique instance involving a 34-year-old healthy male. Following diagnosis, the patient received prompt treatment resulting in excellent outcomes during subsequent follow-ups. Our case report includes a comprehensive analysis of published cases in the literature pertaining to spontaneous nasal septal hematoma and abscess. It is noteworthy that even individuals without preexisting risk factors or a history of trauma can develop a spontaneous NSA or hematoma. Recognizing the condition early and intervening promptly are crucial factors in mitigating potentially serious risks associated with this condition.

Introduction: Nasal septal abscess is the presence of pus between the nasal septum and its mucosa. It Is a rare condition but there are risks of fatal complications if left untreated, it can occur spontaneously or after trauma of nasal septum. Treatments include antibiotics, surgical drainage of abscess, and treatment of its etiology.Case Report: A case of a post-traumatic septal abscess has observed in a 11-year-old child Who was presented with a 5-day history of nasal obstruction, swelling and pain. We have performed incision and drainage with administration of antibiotic, the patient showed satisfactory recovery without any complication.Conclusion: Nasal septal abscess is rare; it can be accompanied by fatal complications if left untreated.

Nasal septal abscess in a newborn is a rare condition. This case report describes a case of nontraumatic, nasal septal abscess in a newborn baby with no evidence of sinusitis or other localized trauma/ infections. A 15-day-old newborn was admitted to a tertiary care hospital with a history of nasal blockage and swelling of the nasal septum. Physical examination revealed a fusiform swelling involving the nasal septum. The patient underwent Diagnostic Nasal Endoscopy with Incision and Drainage followed by 48-hour nasal packing. Neonates being obligate nasal breathers, after drainage, due to the bilateral nasal packs, the otolaryngology and paediatric team had to find a way to make the neonate breathe and swallow simultaneously. The neonate showed gradual improvement following nasal pack removal and had a normal nasal airway on follow-up at 14 days and one-month post-drainage. Even though the septal abscess in neonates is a rare entity however, it can significantly compromise the nasal airway in an obligatory nasal breather, and with limited space for intervention also poses a challenge in managing the condition.

Introduction: Hematomas and septal abscesses are frequent complications of nasal trauma, and they can also appear in the post-surgical period of nasal surgeries, in nasal furunculosis and in dental infectious processes. They are uncommon in the pediatric population [1]. According to the literature, approximately 0.8% of trauma cases are complicated by a septal abscess and 1.6% by a septal hematoma. In many cases, no history of trauma is found [2]. Clinical case: The case of a 19-year-old patient is presented, with no significant pathological history, denies substance use, clinical picture of approximately 3 days that is characterized by facial pain on the left side of the face predominantly nasal, hyaline rhinorrhea, ventilatory insufficiency. Bilateral nasal passages, anosmia and unquantified temperature rises, without apparent cause, denied any history of nasal trauma. Discussion: in this particular case, the unusual location of necrotizing fasciitis in the anterior region of the neck is striking; it generally occurs in people with diabetes mellitus and immunocompromised people and in this case, it occurs without apparent cause. Conclusion: It is concluded that the need for rapid diagnosis and treatment in patients with nasal septal abscess should be emphasized to reduce the risk of infectious complications, permanent functional disorders and aesthetic deformities.

The apex nasi (colloquially, the tip of the nose) is an anatomically complex region that can be divided into 2 parts: the soft tissue/cartilaginous framework of the most anterior-inferior aspect of the nose and the anterior nasal cavity. Detailed knowledge of local anatomy is helpful to characterize pathology and understand patterns of disease spread. Although many lesions of the apex nasi are readily assessed on physical examination, CT and MR imaging can provide important, often complementary, information about this region. CT well demonstrates osseous anatomy, while MR imaging offers increased specificity for certain conditions, given its superior soft-tissue contrast. Regarding specific pathologies of the region, because cutaneous cancers are common and often involve the apex nasi, they will be discussed in detail, along with potential imaging pitfalls such as perineural tumor spread or coexistence with rhinophyma. Certain rare non-neoplastic or developmental lesions, notably nasolabial cysts and pyriform aperture stenosis, are unique to this region. Vascular lesions such as angiosarcoma and venous malformation may involve the apex nasi, as may nasal septal hematoma and abscess, the latter necessitating immediate treatment. Given the high prevalence of rhinoplasty, the imaging appearance of cosmetic nasal implants and selected rare procedural complications is shown.Learning Objective: To describe the anatomic landmarks of the external nose and anterior nasal cavity and to illustrate common and uncommon pathologies in these locations.

This paper reports a 10-year series of spontaneous nasal septal abscesses in immune-competent children, with suggestions for optimal management. A retrospective case note review was conducted of children undergoing an operation for incision and drainage of nasal septal abscesses between 2013 and 2023. Six children were identified via electronic hospital records during the 10-year review period, five with a spontaneous abscess. The children were aged 10-14 years. All were immunocompetent and none had active sinus infection. The most common presenting features were nasal swelling, facial swelling, headache, nasal congestion and fever. The most common bacterial isolate was Staphylococcus aureus. All children received prompt surgical drainage and intravenous antibiotic therapy. Complications were seen in three children, with one child developing significant intracranial complications. To our knowledge, this is the first series of spontaneous nasal septal abscesses in immunocompetent children. The high prevalence of Staphylococcus aureus suggests spread from the nasal mucosa or vestibule. Early recognition, computed tomography scanning, surgical drainage and antibiotic therapy are the mainstays of treatment, to prevent potentially life-threatening complications.

The case of a patient with a septal abscess is reported, with the aim of providing a comprehensive analysis of the diagnostic approach and the various stages of treatment, as well as prompting in-depth reflection on the implications that this particular case could have for medical practice in general. It also highlights the vital importance of early recognition of this condition, and of responding rapidly and appropriately to the patient's needs. It also highlights the value of clinical experience in improving the management of similar cases in the future.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Nasal septal abscess in adult patients - A single center study

BackgroundCOVID-19 is well known to result in pulmonary and multiple extra-pulmonary manifestations. Among them, head and neck manifestations were commonly recognized in the 2nd wave of the pandemic. With the growing global COVID-19 burden, imaging is of utmost importance in diagnosing the disease and its related complications. The study aims to enumerate the various head and neck manifestations and their complications in COVID-19. Additionally, in sinusitis patients, the invasion was correlated with the neutrophil–lymphocyte ratio (NLR).ResultsA cross-sectional observational study in which total of 78 COVID-19 cases that underwent head and neck imaging were retrospectively evaluated. The cohort included 52 males (66.7%) and 26 females (33.3%) with a mean age of 46.19 years (median = 49.0, SD = 16.47). The various head and neck manifestations included non invasive rhinosinusitis (n = 48), invasive sinusitis and its complications (n = 25), nasal septal abscess (n = 1), dacryoadenitis (n = 1), pre-septal and post-septal orbital cellulitis and its complications (n = 13), otitis media, mastoiditis and its complications (n = 6), parotitis (n = 2), neck vessel thrombosis (n = 2) and cervical lymphadenopathy (n = 3). An increase in the invasive nature of sinusitis was demonstrated among patients with comorbidities and elevated NLR.ConclusionsEarly diagnosis and management of head and neck manifestations of COVID-19 are aided by prompt imaging. It is imperative that we are armed with the knowledge of various head and neck manifestations and how they may bear semblance to other pathologies for us to ensure COVID as a differential, especially in the background of known infection.

The nasal septal abscess (NSA) is a rare but potentially fatal disease causing intracranial infection. Treatments for NSA include antibiotics, surgical incision and drainage. Diabetes mellitus (DM) is a risk factor for NSA. Therefore, we assessed the pathogenic bacterial composition of NSA in diabetic patients. We analyzed the Chang Gung Memorial Hospital database to collect 79 NSA patients who received surgical incisions and drainage from 2004 to 2015. We divided them into DM and non-DM groups for analysis. We integrated the bacteria cultured from each patient, listed the top three with the highest frequency and divided the bacterial species into facultative anaerobes or aerobes and anaerobes. The microbiological cultures revealed mono-microbial infection in most of the cases. The top three facultative anaerobes or aerobes with the highest frequency of NSA-DM were Klebsiella pneumoniae (37.5%), methicillin-sensitive Staphylococcus aureus (MSSA; 25%) and methicillin-resistant Staphylococcus aureus (MRSA; 12.5%). The top three for NSA-non-DMs were MSSA (24%), MRSA (20%) and Pseudomonas aeruginosa (16%). The top three anaerobes causing NSA were Prevotella intermedia (25%), Peptostreptococcus species (12.5%) and Propionibacterium acnes (12.5%) in DM patients. The top three in non-DM patients were P. intermedia (25%), P. acnes (16.7%) and Fusobacterium nucleatum (12.5%). When treating NSA in diabetic patients, clinicians should choose empirical antibiotics for K. pneumoniae and P. intermedia, and when treating patients with NSA-non-DM, MSSA and P. intermedia should be considered first.

Nasal septal abscess is a rare and serious infection, due to the complications it can cause. It is defined as a collection of pus between the septal cartilage and its perichondrium. Usually, the abscess is the result of superinfection of a poorly treated post-traumatic hematoma. Rarely, the abscess has spread to the septum either from a skin lesion, sinusitis or dental focus neighborhood but exceptionally the abscess can be spontaneous. We report a case of a 29-year-old girl who presented to the emergency room for rhinological pain associated with bilateral nasal obstruction. The swollen nasal septum completely obstructed the nasal passages. The CT scan showed an abscess of the nasal septum without sinusitis or other infectious ENT focus (spontaneous abscess). Drainage of the abscess associated with a triple antibiotic therapy allowed a favorable outcome. The objective of this case report is to show that nasal septum abscess is another cause of bilateral nasal obstruction. It is not always secondary to a local infection; it can be spontaneous as the case of our patient.

Introduction: Nasal septal abscess (NSA) in the pediatric population is an uncommon condition, but it can cause devastating complications (such as potentially life-threatening intracranial infections and cosmetic nasal deformity). The objective of this study is to report a case of an pediatric patient presenting with NSA in association with frontal-ethmoid acute sinusitis and intracranial abscess. Method and Results: In this study, we report a case of an 8-year-old patient who progressed from spontaneous nasal septal abscess to sinusitis (maxillary, frontal and ethmoidal), cosmetic nasal deformity (destruction of septal cartilage) and intracranial complication. The purulent collection necessitated urgent surgical drainage and adequate medical treatment. Conclusion: Nasal septal abscess in children is a rare condition that necessitates early appropriate drainage in order to prevent severe life-threatening complications. Furthermore, in the growing child, in case of total destruction of the cartilaginous septum, immediate reconstruction with autologous cartilage graft is essential for normal development of the nose and maxilla.

Introduction It has always been a concern of ENT surgeon to prevent post operative complications like nasal bleeding, septal hematoma and septal abscess after septoplasty. Traditionally nasal packing has been done to avoid these complications. Although the nasal pack itself has been a concern for several reasons, packing apart from causing breathing distress, has resulted in epiphora, dysphagia, sleep disturbance, post-operative pain, headache, septal infection, septal abscess and even toxic shock syndrome. Materials and Methods This study has compared the efficacy of a newly designed septal splint with clip with nasal packs. This study was done on 60 patients, nasal packing was done in 30 patients and septal splints with clip were applied in 30 patients. Results Post-operative pain, epiphora, dysphagia, dryness of mouth and sleep disturbance was found to be significantly less in patients with septal splints with clip as compared to those with nasal packing. Conclusion Septal splints with clip is more efficacious alternative to nasal packing in patients undergoing septoplasty.

The spontaneous development of a nasal septal abscess in patients with chronic kidney disease is hardly described in the literature. A 58-year-old man with long-standing type 2 diabetes mellitus and a history of rectal adenocarcinoma was admitted for resection of tumor recurrence. He was initiated on hemodialysis post-operatively due to worsening kidney function. He was discharged on thrice-weekly dialysis but was readmitted two months after for progressive shortness of breath. Further examination revealed severe nasal congestion from a nasal septal abscess which prompted mouth-breathing. Incision and drainage and anterior nasal packing were done, and the patient was discharged improved on broad-spectrum oral antibiotics. This case report highlights the possibility of developing nontraumatic nasal infections in patients with chronic kidney disease due to compromised host defenses.