Korean J Otorhinolaryngol-Head Neck Surg.  2012 Jun;55(6):378-381. 10.3342/kjorl-hns.2012.55.6.378.

A Case of Nasal Septal Abscess Caused by Combined Bacterial and Fungal Infection in the Immunocompromised Patient

• Cho IK
• Chung YJ

• KMID: 2277364
• DOI: http://doi.org/10.3342/kjorl-hns.2012.55.6.378

Abstract

Nasal septal abscess (NSA) occurs more commonly after minor trauma and subsequent bacterial infection. However, it rarely occurs without trauma and can be associated with poor immunity. In the immunocompromised patient, NSA can occur due to fungal as well as bacterial infection; cases caused by fungal infection have been rarely reported. We experienced a case of NSA caused by combined fungal and bacterial infection without trauma in a patient with poorly-controlled diabetes mellitus. He underwent incision and drainage. Organism cultured from NSA was Staphylococcus epidermidis. Pathologic examination identified granulomatous inflammation in the septal cartilage and septate, branching fungal hyphae that had invaded the cartilage. He was treated by adequate blood glucose control and antibiotics coverage without antifungal medications. His symptom was improved despite the antifungal agent was not used. Therefore, we present this case with a brief review of the disease entity and discuss the necessity of antifungal treatment in this case.

Keyword

Nasal septum; Abscess; Fungi

MeSH Terms

Abscess
Anti-Bacterial Agents
Bacterial Infections
Blood Glucose
Cartilage
Diabetes Mellitus
Drainage
Fungi
Humans
Hyphae
Immunocompromised Host
Inflammation
Nasal Septum
Staphylococcus epidermidis
Anti-Bacterial Agents
Blood Glucose