Progressive anosmia revealing olfactory cleft actinomycosis: A CARE case report

Introduction: Progressive anosmia, unlike sudden-onset viral or traumatic anosmia, requires endoscopic screening for nasal polyps. In the absence of polyposis, radiological work-up should diagnose and treat any curable pathology. Here, we report the case of a patient treated for olfactory cleft actinomycosis.

Results: A 72 year-old man, without relevant medical history, was referred for progressive hyposmia and unilateral greenish rhinorrhea resistant to well-conducted medical treatment. Nasal endoscopy and imaging suggested a fungus ball in the left olfactory cleft. Endoscopic surgery fully restored olfaction, with histologic confirmation of actinomycetes.

Discussion: The present case highlights the importance of prompt diagnosis in progressive anosmia, and demonstrates the efficacy of exclusively surgical management.