ABSTRACT
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
Subject(s)
Humans , Male , Adult , Nose Diseases/diagnosis , Nose Diseases/chemically induced , Cocaine-Related Disorders/complications , Nasal Septum/drug effects , Magnetic Resonance Imaging , Tomography Scanners, X-Ray Computed , Granulomatosis with Polyangiitis/diagnosis , Nose Diseases/therapy , Diagnosis, Differential , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/therapeutic useABSTRACT
Se estudian los efectos de la cocaína a nivel otorrinológico, encontrándose que es la nariz el órgano afectado por el uso de la droga. La patología nasal está fuertemente vinculada a factores como patrón de uso, cantidad aspirada y tiempo de consumo. Asimismo las lesiones pueden ser reversibles o irrevesibles. Entre las segundas se destacan la rinitis atrófica y la perforación septal. Son lesiones reversibles la rinitis costrosa, la obstrucción nasal y la congestión perinasal. Se describe una lesión macular del tabique, que puede ser patognomónica del uso de la droga