The middle facial necrosis is a rare pathology that can be found related to multiple processes that can provoque it: traumatic, chemical, infections, inflammatory and tumorals. So for its diagnosis we require a wide differential diagnosis. We present a clinic case of a nose aspirated cocaine female patient who came to our department with a middle-facial necrosis not telling to us in the anamnesis the cocaine use. We were obliged to do multiple diagnostic tests searching other possible causes.
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