Quora, Nasal Pain and Discharge

My Quora Answer to the Question:

As a doctor, what have you extracted from a patient that nearly scared you?

A patient experienced two months of facial pain, green nasal discharge, and fetid breath. There was no history of fever, sore throat, or Upper Respiratory Infection symptoms other than the facual pain and discharge. The pain was constant, dull, and worse on both sides of his nose. He had no history of sinusitis, and the rest of his personal medical history was unremarkable.

On exam, he was awake, alert, and in no apparent distress. Heart rate was 95 BPM and temperature 98.6 degrees F. Skin was warm and dry, mucous membranes moist, and without edema or erythema.

Voice was nasally but with a regular rate. He was tender to palpation bilaterally to his nose. Nasal mucous membranes were edematous on speculum exam, which also revealed two bright blue objects, one in each nostril. I removed them with forceps and discovered that they were foam earbud coverings. On further questioning, it turned out that he had inserted them into his nose about two months earlier.

The patient was my two year old son Benny.


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