{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:54:15Z","timestamp":1763463255192,"version":"3.45.0"},"reference-count":39,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health of Ukraine","award":["0123U100153"],"award-info":[{"award-number":["0123U100153"]}]},{"DOI":"10.13039\/100018227","name":"National Research Foundation of Ukraine","doi-asserted-by":"publisher","award":["2023.03\/0104","2023.05\/0021"],"award-info":[{"award-number":["2023.03\/0104","2023.05\/0021"]}],"id":[{"id":"10.13039\/100018227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Atrophic rhinitis (AR) is a rare, chronic inflammatory condition characterized by progressive atrophy of the nasal mucosa and underlying bone. The present report describes a case of severe secondary AR as a sequela of COVID-19-associated necrotizing rhinitis, highlighting the diagnostic and management challenges posed by multi-drug resistant pathogens and extensive anatomical destruction. Case Presentation: A 75-year-old female developed progressive necrotizing rhinosinusitis with osteomyelitis following a COVID-19 infection. Computed tomography (CT) confirmed an osteolytic process and subsequent profound anatomical destruction, while histopathology ruled out invasive fungal disease. The resulting cavity was colonized by multi-drug resistant Pseudomonas aeruginosa and Staphylococcus aureus. Management and Outcome: Management focused on preventing crust formation through a structured \u201cnasal rest\u201d protocol, supplemented by cleansing nasal douching with a surfactant (baby soap) and mechanical crust removal. This treatment led to significant clinical improvement, with reduced crusting and complete resolution of ozena symptoms. Conclusions: This case illustrates the potential for SARS-CoV-2 infection to precipitate severe necrotizing sinonasal complications leading to secondary AR. It demonstrates the efficacy of a management strategy focused on mechanical cleansing and nasal rest, particularly when conventional antibiotic therapy is limited by extensive drug resistance.<\/jats:p>","DOI":"10.3390\/reports8040237","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T09:58:42Z","timestamp":1763459922000},"page":"237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe Secondary Atrophic Rhinitis with Extensive Osteomyelitis Following COVID-19-Associated Necrotizing Rhinitis: A Case Report and Microbiological Analysis"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0464-2480","authenticated-orcid":false,"given":"Anton","family":"Danylevych","sequence":"first","affiliation":[{"name":"Lviv Territorial Medical Union \u00abMultidisciplinary Clinical Hospital of Emergency and Intensive Care\u00bb, Mykolaichuka St., 9, 79059 Lviv, Lviv Region, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofiya","family":"Tsolko","sequence":"additional","affiliation":[{"name":"Lviv Territorial Medical Union \u00abMultidisciplinary Clinical Hospital of Emergency and Intensive Care\u00bb, Mykolaichuka St., 9, 79059 Lviv, Lviv Region, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-9412","authenticated-orcid":false,"given":"Iryna","family":"Tymechko","sequence":"additional","affiliation":[{"name":"Dolishniy Institute of Regional Research,  National Academy of Sciences of Ukraine, Kozelnytska St., 4, 79034 Lviv, Lviv Region, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-0525","authenticated-orcid":false,"given":"Olena","family":"Korniychuk","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Danylo Halytsky Lviv National Medical University, Zelena St., 12, 79010 Lviv, Lviv Region, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4789-1675","authenticated-orcid":false,"given":"Yulian","family":"Konechnyi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Danylo Halytsky Lviv National Medical University, Zelena St., 12, 79010 Lviv, Lviv Region, Ukraine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","first-page":"56","article-title":"Nasal Secretion Insufficiency Syndrome (New Concept of Ozena)","volume":"7","author":"Takami","year":"2020","journal-title":"J. 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