COCAINE INDUCED MIDLINE DESTRUCTIVE LESIONS. REPORT OF ONE CASE.

Lesiones destructivas de la línea media facial secundarias al consumo de cocaína. Caso Clínico

Author
Barrera O, Manuel; Universidad de los Andes

De la Rivera V, Matías; Universidad de los Andes

Vela U, Javier; Universidad de los Andes

Barrera M, Rodrigo; Universidad de los Andes

Monckeberg F, Gustavo; Universidad de los Andes

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http://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/6841
Abstract
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
 
Vasculitic midline destructive lesions can be a complication of cocaine use. We report a 44-year-old man who presented with a two months history of left facial pain associated with ipsilateral facial paralysis and a cheek phlegmon. Magnetic resonance imaging showed broad soft tissue destruction linked to important cranial nerve involvement. Antibiotic and antifungal therapy was started and multiple surgical debridement procedures were performed, with no clinical improvement. Microbiological analysis was negative. Finally, thanks to the histologic findings corresponding to vasculitis and granuloma formation and the history of cocaine abuse, a cocaine induced midline destructive lesion was diagnosed.
 
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