A Case of Nasal Septal Abscess Caused by Careless Ointment Application

Nasal septal abscess has rarely been encountered in clinical practice in recent years. We report the case of a 75-year-old man who had a nasal septal abscess, probably caused by nasal tinkering. The patient presented with an approximately 1-year history of episodes of nasal bleeding. He had been prescribed an ointment for topical nasal application by a neighborhood doctor and had applied the ointment with his fingers. He then visited the local doctor with complaints of nose pain, low-grade fever, and nasal congestion. As the symptoms did not improve with the prescribed treatment, he was referred to our hospital. Medical examination at our department led to the suspicion of nasal septal abscess; therefore, an incision was made under local anesthesia, followed by administration of antibiotic and steroid therapy for 4 days. However, this treatment also failed, and local incision and drainage was repeated under local anesthesia in the operating room. The abscess resolved, and no recurrence has been observed for 6 months after the operation, and there are no sequelae, such as saddle nose. With the advances in the development of effective antibacterial drugs, nasal septal abscess has become a rarely encountered disease in recent years. However, the clinical course of cases with severe nasal septal abscess can be complicated by meningitis and sepsis. There is also the possibility of sequelae, such as saddle nose, after treatment. In patients presenting with symptoms such as nasal obstruction, nasal pain, and low-grade fever, it is important to have a high index of suspicion and make an early diagnosis of nasal septal abscess by proactive endoscopy. In this patient reported herein, the traumatic effect of frequent application of an ointment with unwashed fingers for about one year was considered to have caused a nasal septal abscess.