UNASSIGNED: A 10-year-old girl presented with acute nasal obstruction, otalgia, and headache. Medical history was negative; physical examination and anterior rhinoscopy did not reveal signs of acute rhinosinusitis or septal abscess.
UNASSIGNED: A thorough nasal endoscopy was performed to rule out a posterior nasal infection, revealing a bilateral posterior septal bulging, in the absence of purulent discharge. CT scan and contrast-enhanced MRI were performed, confirming the diagnosis of a spontaneous posterior septal abscess. Trans-nasal endoscopic-assisted drainage was conducted under general anesthesia. Haemophilus influenzae was detected on culture.
UNASSIGNED: Although rare, nasal septal abscess in the pediatric age is typically anterior and secondary to local trauma or infection. Accurate medical history and anterior rhinoscopy are usually sufficient to make the diagnosis. In cases where the clinical presentation is consistent with a nasal septal abscess, with no history of recent local trauma or infection, or signs of anterior septal bulging, nasal endoscopy should be performed to rule out spontaneous posterior septal abscess. Delay in diagnosis and treatment could potentially cause the rapid onset of life-threatening complications, including intracranial abscess, meningitis, and cavernous sinus thrombosis.
■一名10岁女孩出现急性鼻塞,耳痛,和头痛。病史阴性;体格检查和前鼻镜检查未发现急性鼻-鼻窦炎或间隔脓肿的迹象。
■进行了彻底的鼻内窥镜检查以排除后部鼻腔感染,显示双侧后间隔膨出,在没有脓性分泌物的情况下。进行CT扫描和增强MRI检查,确认诊断为自发性后间隔脓肿。在全身麻醉下进行经鼻内镜辅助引流。在培养物中检测到流感嗜血杆菌。
■虽然罕见,儿童年龄的鼻中隔脓肿通常是前部的,继发于局部创伤或感染。准确的病史和前鼻镜检查通常足以做出诊断。如果临床表现与鼻中隔脓肿一致,近期无局部外伤或感染史,或者前间隔膨出的迹象,应进行鼻内镜检查以排除自发性后间隔脓肿。诊断和治疗的延迟可能会导致危及生命的并发症的快速发作,包括颅内脓肿,脑膜炎,海绵窦血栓形成.