PT - JOURNAL ARTICLE AU - Fatima Sarwar AU - Sana Sheikh AU - Naqeeb Ullah Khan AU - Syeda Nidaa Fatima TI - Tubercular septal abscess in a postoperative patient: a novel entity AID - 10.1136/bcr-2018-224892 DP - 2018 Sep 10 TA - BMJ Case Reports PG - bcr-2018-224892 VI - 2018 4099 - http://casereports.bmj.com/content/2018/bcr-2018-224892.short 4100 - http://casereports.bmj.com/content/2018/bcr-2018-224892.full AB - 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.