In a bizarre medical case, a teenager who simultaneously experienced a loss of smell but emitted an inexplicable “foul odor” whenever he blew his nose over a period of eight years, finally discovered the culprit.
According to a recent report in the journal JAMA Otolaryngology ‒ Head & Neck Surgery, the boy first presented to doctors when he was 15 years old with an impaired sense of smell.
Doctors performed an endoscopy on the teen’s nose to determine the cause. They quickly noticed the boy had a condition known as “turbinate hypertrophy,” in which the tubes in his nasal passage had become enlarged, a condition often associated with allergies or inflammation in the sinuses.
The doctor prescribed nasal spray and a course of antihistamines to treat the apparently mundane condition.
However, the teen returned a year later, aged 16, with no discernible improvement in his nasal symptoms. In fact, he began expelling “a pungent, foul odor [which]filled the room,” the report authors said.
It was at this point the baffled doctors sent the boy for a CT scan which revealed the olfactory offender: a 9mm sphere lodged in his nasal cavity which was later identified as a metallic BB gun pellet.
When doctors revealed the culprit, the family remembered that the boy had indeed been shot in the nose with a pellet gun several years prior to visiting the doctor initially, when he was around eight or nine years old.
“The foreign body causes blockage of natural drainage pathways in the nose, so there is a buildup of mucus, inhaled debris and bacteria,” said co-author Dylan Z. Erwin, a medical student at the University of Texas Health Science Center at San Antonio.
The dearth of symptoms in the first few years meant the foreign body wasn’t undetected and the putrid concoction was allowed to ‘mature’ within the tissue of the boy’s nose, as “healthy-appearing tissue had completely grown over it.”
The boy underwent surgery to remove the pellet, his sense of smell was restored and, mercifully for his family and friends, the pungent odor he expelled every time he blew his nose stopped.
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