経済的問題のために急性副鼻腔炎の治療経過が遷延した1例

抄録

Under normal circumstances, acute sinusitis is treated with antibiotics. If antibiotics are ineffective, endoscopic surgery provides an alternative therapy that only requires a short period of time to perform. We herein report a case of acute sinusitis that, for financial reasons, had a prolonged clinical course. A 52-year-old Japanese man, who was complaining of long-lasting left nasal obstruction and left facial swelling, was referred to our hospital. A computerized tomography scan revealed acute sinusitis and an old facial bone fracture that was causing facial cellulitis. Owing to financial issues, the patient refused endoscopic surgery as a treatment option. He was therefore treated with a long-term course of antibiotics. After 2 months had passed, the patient agreed to undergo an operation and endoscopic surgery was performed. The left maxillary sinus was filled with pus and was thus removed and thoroughly washed. Fungal masses were also observed in the sinus. After surgery, the patient recovered without any complications. This case suggests that it is important to be aware if a patient is reluctant to receive appropriate treatment for financial reasons. Preparations should be made for such instances, and social and private assistance, such as that from medical social workers, should be made available to the patient where possible.