Rare spontaneous development of nasal septal abscess in end-stage kidney disease

@#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.

Invasive Aspergillosis Associated Bacterial Infection in the Nasal Septum After Sphenoid Sinus Surgery / 대한이비인후과학회지

Nasal septal infection can result from progression of a fungal infection from the adjacent sinuses. Nasal septal fungal abscesses complicating nasal trauma, surgical procedures, sinus, and dental infections have previously been reported in a small number of cases. Adequate management involves early diagnosis, prompt empiric antifungal therapy, and surgical debridement in order to prevent the development of life-threatening complications. We report a rare case of nasal septum necrosis from Aspergillus infection in a 79-year-old man with diabetes mellitus and chronic renal failure following endoscopic sphenoid sinus surgery due to an isolated sphenoid fungal ball.

Postoperative Septal Abscesses According to the Techniques of the Septoplasty

BACKGROUND AND OBJECTIVES: Recently, the swinging door and grafting techniques have been heavily used for straightening and holding the caudal septum. However, reconstructive septoplasties require more extensive dissection of septal structures. Extensive anatomical dissection and complicated procedures may affect the probability of postoperative bleeding and infection. MATERIALS AND METHOD: We retrospectively reviewed the records of 141 consecutive patients who underwent septal surgeries from February 2013 to December 2015. The patients were classified into two groups according to surgical technique: those who underwent submucous resection with or without endoscopy were classified as the “resection” group, while those who underwent the swinging door or batten graft technique were classified as the “reconstruction” group. The resection and reconstruction groups were matched using the propensity score. The incidence of postoperative septal abscesses (PSAs) was analyzed between the two groups. RESULTS: For the two groups, 36 patients were matched with 36 patients (1:1) using the propensity score. Of the 72 patients, PSAs developed in 5 patients (6.9%). One patient was in the resection group (2.8%), while the other four patients were in the reconstruction group (11.1%). However, the incidence of PSAs was not significantly higher in the reconstruction group according to Fisher's exact test (p=0.164). CONCLUSION: Reconstructive septoplasty resulted in more septal abscesses than resection, but the difference was not significant.