ECE2023 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (355 abstracts)
Nasal septal abscess in patients with type 2 diabetes mellitus: A report of 2 cases
Houas Jihene 1 , Naouar Maroua 1 , Ghammam Monia 1 , Bergaoui Emna 1 , El Omri Malika 1 , Bellakhdher Mouna 1 , Hasni El Abed Yosra 2 , Meherzi Abir 1 , Kermani wassim 1 & Abdelkefi Mohamed 1
1ENT Department and Neck Surgery of Farhat Hached Hospital, Sousse, Tunisia; 2Endocrinology Department Farhat Hached Hospital, Sousse, Tunisia.
Introduction: A nasal septal abscess (NSA) is defined as a collection of pus between the cartilage or bony septum and its mucoperichondrium or mucoperiostium. NSA caused by uncontrolled diabetes mellitus are rare. The aim of this study is to focus on the association between diabetes mellitus and NSA.
Materials and methods: We report two rare cases of NSA in patients with type 2 diabetes mellitus collected in ENT department of Farhat Hached Hospital of Sousse over a period of 10 years.
Results: Case one was a 80-year-old woman, with history of diabetes mellitus, hypothyroidism and on oral hypoglycemic medication, presented with a nasal block and purulent nasal discharge for 6 days. There was no history of trauma, sinusitis or any surgical procedures. Direct nasoendoscopy showed a bilateral septal swelling at the anterior aspect. Random blood sugar was 20.3 mmol/l. She had a surgical incision and drainage. The patient was started on IV cefotaxime and metronidazole than Clindamycin. She was started on sliding scale insulin for rapid blood sugar control. The microbiological examination showed Staphylococcus aureus. The follow-up was marked by the recurrence of the NSA leading to a revision surgery. No reccurence was noted. The second case was a 47-year-old man, with history of diabetes mellitus, on oral hypoglycemic medication, presented with an inflammatory nose swelling associated with bilateral nasal obstruction. He had no history of sinusitis, trauma or surgery. On examination, the patient had a fever at 39°c. The tip the nose showed localized edema and erythema with a healed carbuncles. Direct nasoendoscopy revealed bilateral septal swelling at the anterior aspect and bilateral inferior turbinate hypertrophy. Random blood sugar was 23 mmol/l. The treatment consisted on a surgical drainage and intravenous antibiotic therapy (cefotaxime and metronidazole). He was started on sliding scale insulin for rapid blood sugar control. Bacteriological examination showed Staphylococcus aureus. We noted the recurrence of the NSA within 7 days leading to a revision surgery. No reccurence was noted.
Conclusion: Nasal septal abscess is a rare condition. However uncontrolled diabetes should be considered as a condition in any patient with nasal septal abscess when trauma is excluded. Therefore prompt treatment should be given to prevent serious cosmetic nasal deformity and intracranial complications.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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