Visual Diagnosis in Emergency Medicine
Spontaneous Nasal Septal Abscess

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Case Report

A 58-year-old man was referred to our hospital with a 2-week history of nasal obstruction, pain, and intermittent fever. He had visited two other hospitals, where oral antibiotics and local treatment of the nose had been given. He had no recent history of nasal trauma, surgery, sinusitis, or dental infections. Physical examination revealed bulging septal mucosa occupied his bilateral nasal cavity (Figure 1A and 1B). Maxillofacial computed tomography with contrast showed a hypodense lesion with

Discussion

Nasal septal abscesses are uncommon in the modern era because antibiotics are available. The most common cause of a nasal septal abscess is an infected hematoma following nasal trauma, which may be associated with accidents, septal surgery, chronic irritation, nasogastric intubation, and nasal furuncle 1, 2. Some causes are secondary to odontogenic lesions, sinusitis, and incidental factors.

Nasal septal abscesses are more common in children and in males (3). The presenting symptoms of a nasal

Acknowledgments

This work was supported in part by a grant from the Tri-Service General Hospital, Taiwan (TSGH-C108-037 to H.C. Chen).

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