Irish medical journal · 2022
Oro-Naso-Sino-Orbital-Cutaneous Fistula From Prolonged Cocaine Use.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Boyle S, Hussain M, Kirby C, Brennan S, Clarke L, Mullan R, Halpenny D, Conlon N, Little M A, Conlon B J, Abdulrahman S
Аннотация
Presentation We present the case of a 48-year-old man with nasal cellulitis and subsequent oro-naso-sino-orbital-cutaneous fistula from prolonged cocaine use. Diagnosis Initial laboratory investigations reported a raised white cell count (WBC) and C-Reactive Protein (CRP) and subsequently a positive atypical anti-neutrophil cytoplasm antibodies (ANCA) and positive anti-proteinase (PR3). Perihilar lung nodularity on chest imaging raised the possibility of a systemic autoimmune response. His urinalysis was positive for cocaine. Treatment He was commenced on Augmentin, Amphotericin B and Prednisolone. An obturator was created to manage the oro-nasal fistula. A subsequent naso-cutaneous defect was re-approximated. Daily nasal saline douche and abstinence of cocaine were recommended. Discussion Cocaine use in the community is rising and poses a challenge to multiple facets of our health care system.