BMJ Case Reports 2018; doi:10.1136/bcr-2018-224892
  • Rare disease

Tubercular septal abscess in a postoperative patient: a novel entity

  1. Syeda Nidaa Fatima2
  1. 1Department of Paediatrics, KRL Hospital, Islamabad, Pakistan
  2. 2ENT, KRL Hospital, Islamabad, Pakistan
  3. 3Department of Epidemiology, KRL Hospital, Islamabad, Pakistan
  1. Correspondence to Dr Naqeeb Ullah Khan, naqeeb16{at}
  • Accepted 11 July 2018
  • Published 10 September 2018


Extrapulmonary tuberculosis is a rather uncommon and potentially challenging phenomenon. Such manifestation, particularly in the scenario of a late postoperative period, is extremely rare and requires a high index of suspicion, prompt diagnosis and appropriate treatment.

We present the case scenario of a patient with history of successfully treated pulmonary tuberculosis many years earlier, without any signs of recurrence, who developed primary nasal septal tuberculosis after undergoing septoplasty to correct his septal deviation. His postoperative course remained uneventful for 4 months. He then presented with a spontaneous nasal septal abscess, which proved to be tubercular in nature on investigations. Appropriate diagnosis was established, and the patient was treated successfully with antituberculous therapy.

Recurrent tuberculosis may present a diagnostic challenge for healthcare professionals. Only a high index of suspicion, modern diagnostic tools and institution of appropriate treatment including surgical intervention as required will ensure a promising outcome.


  • Contributors FS is a house officer. She assisted and managed this case and selected it for publication. She wrote the abstract, case presentation, investigations and treatment and sections of this article. SS is a postgraduate trainee doctor. She assisted the operation and wrote the Discussion section of the article. She also provided help in writing of the Investigations and Treatment sections. NUK is a consultant epidemiologist and an experienced researcher. He critically reviewed the whole manuscript, edited and drafted and gave a final touch to the report and made it ready for publication. SNF is a postgraduate trainee doctor. She did extensive literature search and provided references for the article. She also helped other authors and managed the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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