Bacterial Nasal Infections
Nasal vestibulitis is bacterial infection of the nasal vestibule, typically with Staphylococcus aureus. It may result from nose picking or excessive nose blowing and causes annoying crusts and bleeding when the crusts slough off. Bacitracin or mupirocin ointment applied topically bid for 14 days is effective.
Furuncles of the nasal vestibule are usually staphylococcal; they may develop into spreading cellulitis of the tip of the nose. Systemic antistaphylococcal antibiotics (eg, cephalexin 500 mg po qid) are given and warm compresses and topical mupirocin are applied. Furuncles are incised and drained to prevent local thrombophlebitis and subsequent cavernous sinus thrombosis.
Treatment of community-associated methicillin-resistant S. aureus infections should be directed by culture and sensitivity test results. Typically, clindamycin, trimethoprim/sulfamethoxazole, and doxycycline are effective against most strains.