RESUMO
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.
Assuntos
Humanos , Masculino , Adulto , Doenças Nasais/diagnóstico , Doenças Nasais/induzido quimicamente , Transtornos Relacionados ao Uso de Cocaína/complicações , Septo Nasal/efeitos dos fármacos , Imageamento por Ressonância Magnética , Tomógrafos Computadorizados , Granulomatose com Poliangiite/diagnóstico , Doenças Nasais/terapia , Diagnóstico Diferencial , Antibacterianos/classificação , Antibacterianos/uso terapêuticoRESUMO
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.
