Am J Otolaryngol Head Neck Surg | Volume 2, Issue 8 | Case Series | Open Access
Alan Shikani, Nadim Khoueir and Diptarka Bhattacharyya*
Department of Otolaryngology, Maryland Nose and Sinus Center, USA
*Correspondance to: Diptarka Bhattacharyya
Fulltext PDFAtypical mycobacterium is unusual causes of refractory Chronic Rhinosinusitis (CRS) and there is no universally accepted therapeutic regimen for this disease in the otolaryngology literature. Treatment can be a challenge as resistance to oral antibiotics often develops with time, necessitating long-term intravenous antibiotics which carry the risk of significant morbidity. We present a case of refractory CRS secondary to Mycobacterium abscessus in an immunocompetent patient. The organism was resistant to oral macrolides and the patient declined intravenous antibiotics. He was successfully treated with a long-term topical sinus therapy regimen that we had previously developed for refractory bacterial CRS (the “rhinotopic protocol”) and remained disease free for a period of four years. Topical therapy can provide mucosal antibiotic levels which are above the required minimal minimum bactericidal concentration, without the risks of systemic toxicity. Rhinotopic therapy can be a valuable option in refractory CRS caused by multi-resistant atypical mycobacteria.
Chronic rhinosinusitis; Atypical mycobacteria; Mycobacterium abscessus; Rhinotopic therapy
Shikani A, Khoueir N, Bhattacharyya D. Rhinotopic Therapy for Atypical Mycobacterial Infections of the SinoNasal Tract: Case Report and Review of the Literature. Am J Otolaryngol Head Neck Surg. 2019; 2(8): 1067.