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Whenever This Boy Blew His Nose, A "Foul Odor Filled The Room"

Discussion in 'Otolaryngology' started by Mahmoud Abudeif, Mar 5, 2021.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    A 16-year-old boy went to the doctors recently with a strange complaint: Whenever he blew his nose, a pungent and unpleasant smell would fill the room.

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    The boy first sought medical attention at 15, following several years of congestion and a lack of sense of smell. Aside from these symptoms - and a few allergies - he was perfectly healthy, showed no sign of tonsilitis or other disorders, and did not drink or smoke.

    The team performed a nasal endoscopy on the patient, finding no signs of anything of concern, such as masses or lesions. With no obvious cause, he was sent away with nasal rinses, intranasal steroid spray and antihistamines, and told to return in 4-6 weeks, doctors write in the journal JAMA Otolaryngology–Head & Neck Surgery.

    He didn't show. A year later, when he did return, it was with a new symptom: The foul odor that came out of his nose when he blew.

    Despite the smell from his nose, he reported no bad breath. A CT scan was performed, at which point a small 9mm "spherical structure" was found lodged up in his nasal cavity. Around the sphere were deposits of calcium which can be caused by chronic inflammation, necrosis or scarring, an indication that the structure was a foreign body.

    He was taken to have the object removed. After gentle suction, the area began to bleed, before the cause of his troubles finally fell out: a small metalic bullet from a BB gun. After a discussion with the family, they discovered that he had been shot in the nose when he was 8 or 9 years old, and it had been stuck up there ever since, causing the smell.

    "The foreign body causes blockage of natural drainage pathways in the nose, so there is a buildup of mucus, inhaled debris and bacteria," co-author Dylan Z. Erwin, a medical student at The University of Texas Health Science Center at San Antonio, told Live Science.

    As he hadn't had any symptoms at the time, the family thought nothing of it, and believed the problems at 15 were unrelated. Healthy tissue had grown over the BB gun, making dislodging it with a sneeze impossible.

    The boy didn't suffer any severe infection, and once the BB was taken out, he was able to blow his nose again without stinking up the place.

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