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Meshref M, Nourelden AZ, Elshanbary AA, AbdelQadir YH, Zaazouee MS, Ragab KM, Ahmed EMS, Swed S. Subdural empyema due to mixed infections successfully treated medically: A case report with review literature. Clin Case Rep 2022; 10:e6049. [PMID: 35846899 PMCID: PMC9280757 DOI: 10.1002/ccr3.6049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/20/2022] [Accepted: 06/25/2022] [Indexed: 11/12/2022] Open
Abstract
Subdural empyema is a rare intracranial infection with an accumulation of purulent material between the dura and arachnoid matter. We report a case of 17 years old presented with an altered conscious level. CSF analysis showed increased WBCs. His situation has improved after treating by acyclovir, ceftriaxone, vancomycin, and dexamethasone. Subdural empyema is a rare intracranial infection with an accumulation of purulent material between the dura and arachnoid matter. We report a case of 17 years old presented with an altered conscious level. CSF analysis showed increased WBCs. His situation has improved after treating by acyclovir, ceftriaxone, vancomycin, and dexamethasone. Bacterial infection medical treatment meningeal irritation subdural empyema viral infection.
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Affiliation(s)
| | - Anas Zakarya Nourelden
- Faculty of Medicine Al‐Azhar University Cairo Egypt
- International Medical Research Association (IMedRA) Cairo Egypt
| | - Alaa Ahmed Elshanbary
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Yossef Hassan AbdelQadir
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Alexandria University Alexandria Egypt
| | - Mohamed Sayed Zaazouee
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Al‐Azhar University Assiut Egypt
| | - Khaled Mohamed Ragab
- International Medical Research Association (IMedRA) Cairo Egypt
- Faculty of Medicine Minia University Minia Egypt
| | | | - Sarya Swed
- Faculty of Medicine Aleppo University Aleppo Syria
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2
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Borni M, Znazen M, Kolsi F, Zaher Boudawara M. Clinico-radiological assessment and therapeutic management of intracranial suppurations: Bicentric series of 43 cases with literature review. INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2021.101393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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3
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Leung AK, Hon KL, Chu WC. Acute bacterial sinusitis in children: an updated review. Drugs Context 2020; 9:dic-2020-9-3. [PMID: 33281908 PMCID: PMC7685231 DOI: 10.7573/dic.2020-9-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022] Open
Abstract
Background In the pediatric age group, approximately 7.5% of upper respiratory tract infections (URIs) are complicated by acute bacterial sinusitis (ABS). Despite its prevalence, ABS is often overlooked in young children. The diagnosis and management present unique challenges in primary care. This is an updated narrative review on the evaluation, diagnosis, and management of ABS. Methods A PubMed search was performed using the key term ‘acute sinusitis’. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English literature and children. Results Haemophilus influenzae (non-typeable), Streptococcus pneumoniae, and Moraxella catarrhalis are the major pathogens in uncomplicated ABS in otherwise healthy children. In complicated ABS, polymicrobial infections are common. The diagnosis of acute sinusitis is mainly clinical and based on stringent criteria, including persistent symptoms and signs of a URI beyond 10 days, without appreciable improvement; a URI with high fever and purulent nasal discharge at onset lasting for at least 3 consecutive days; and biphasic or worsening symptoms. Conclusion Data from high-quality studies on the management of ABS are limited. The present consensus is that amoxicillin-clavulanate, at a standard dose of 45 mg/kg/day orally, is the drug of choice for most cases of uncomplicated ABS in children in whom antibacterial resistance is not suspected. Alternatively, oral amoxicillin 90 mg/kg/day can be administered. For those with severe ABS or uncomplicated acute sinusitis who are at risk for severe disease or antibiotic resistance, oral high-dose amoxicillin-clavulanate (90 mg/kg/day) is the drug of choice.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, and The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
| | - Winnie Cw Chu
- Department of Imaging & Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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4
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Craig JR, Tataryn RW, Aghaloo TL, Pokorny AT, Gray ST, Mattos JL, Poetker DM. Management of odontogenic sinusitis: multidisciplinary consensus statement. Int Forum Allergy Rhinol 2020; 10:901-912. [PMID: 32506807 DOI: 10.1002/alr.22598] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/09/2020] [Accepted: 04/27/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Odontogenic sinusitis (ODS) can present a therapeutic dilemma because multiple treatment strategies have been reported. ODS review articles have been published, but they have lacked multidisciplinary collaboration and an evidence-based methodology. The purpose of this article was to perform an evidence-based review of ODS management options, and develop a multidisciplinary consensus statement on ODS management options. METHODS An evidence-based review of dental and medical literature on ODS management was performed using PubMed, EMBASE, and Cochrane Review Databases up to December 2019. Exclusion criteria included non-English-language articles, case series with fewer than 10 patients, fungal sinusitis, and studies that did not report treatment success rates. Because aggregate levels of evidence for recommendations were no higher than level C, a clinical consensus statement was conducted using a modified Delphi method. RESULTS Sixteen articles met inclusion criteria for the evidence-based review on the following ODS management options: dental treatment alone or combined with ESS for various dental pathologies, and endoscopic sinus surgery (ESS) alone for dental implant-related ODS. Strong consensus was achieved for 9 of the 10 clinical statements, the strongest being the use of shared decision-making for selecting management strategies. No consensus was reached for determining the extent of ESS necessary for uncomplicated ODS. CONCLUSION Strong consensus was reached that ODS management should involve shared decision-making between the otolaryngologist, dental provider, and patient, where the benefits and risks of dental treatment and ESS are discussed. Higher-quality studies are necessary to develop evidence-based treatment recommendations for ODS.
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Affiliation(s)
- John R Craig
- Department of Otolaryngology, Henry Ford Health System, Detroit, MI
| | - Roderick W Tataryn
- Tataryn Endodontics, Spokane, WA.,Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA
| | - Tara L Aghaloo
- University of California, Los Angeles (UCLA) School of Dentistry, UCLA, Los Angeles, CA
| | - Alan T Pokorny
- Spokane ENT Clinic, Spokane, WA.,Department of Otolaryngology, University of Washington, Seattle, WA
| | - Stacey T Gray
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA
| | - Jose L Mattos
- Department of Otolaryngology, University of Virginia, Charlottesville, VA
| | - David M Poetker
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, WI
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5
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Diouf MS, Tall A, Ndiaye C, Thiam A, Deguenonvo R, Ndiaye M. Complications of sinusitis: An 80-case series from the ENT and neurosurgery departments of the Fann university hospital center of Dakar, Senegal. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:473-476. [PMID: 32280049 DOI: 10.1016/j.anorl.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Locoregional complications of sinusitis are dominated by oculo-orbital and/or cranioencephalic manifestations that may be life-threatening or jeopardize functional prognosis. The aim of this study was to report epidemiological, diagnostic and therapeutic aspects. MATERIALS AND METHODS A retrospective study included inpatients managed for sinusitis complications in the ENT and neurosurgery departments of the Fann university hospital center in Dakar, Senegal between January 1, 2005 and December 31, 2016. RESULTS In all, 80 files were collected. Mean age was 18.5 years, with male predominance. Mean time to treatment was 18.2 days. Cranio-encephalic complications were the most frequent (54 cases; 67.5%): mainly subdural empyema (30 cases) and brain abscess (10 cases). Seventeen patients (21.25%) had oculo-orbital complications: mainly orbital cellulitis (52.9%) and preseptal cellulitis (29.4%). Nine patients (11.25%) had both cranioencephalic and oculo-orbital complications. Acute sinusitis (82.5%) was the main cause of complications. 52.5% of patients showed pansinus involvement. Medical treatment consisted in broad-spectrum antibiotic therapy combining third-generation cephalosporins, metronidazole and gentamycin in cranio-encephalic complications and clavulanic acid and metronidazole in oculo-orbital complications. Thirty-four patients (42.5%) underwent surgical sinus drainage. Neurosurgical drainage was performed in 35 cases (43.75%). Post-treatment course was marked by 6.25% mortality (5 cases) and 16.25% sequelae. CONCLUSION With 6.25% mortality and a high rate of functional sequelae, complications of sinusitis are a serious concern in our region. Improving prognosis requires earlier management and better coordination between health professionals.
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Affiliation(s)
- M S Diouf
- Université Cheikh Anta Diop, Dakar, Senegal.
| | - A Tall
- Université Cheikh Anta Diop, Dakar, Senegal
| | - C Ndiaye
- Université Cheikh Anta Diop, Dakar, Senegal
| | - A Thiam
- Hôpital Général de Grand Yoff, Dakar, Senegal
| | | | - M Ndiaye
- Université de Thies, Thies, Senegal
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Vidal F, Coutinho TM, Carvalho Ferreira DD, Souza RCD, Gonçalves LS. Odontogenic sinusitis: a comprehensive review. Acta Odontol Scand 2017; 75:623-633. [PMID: 28877613 DOI: 10.1080/00016357.2017.1372803] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.
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Affiliation(s)
- Fábio Vidal
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | | | - Dennis de Carvalho Ferreira
- PostGraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
- Oral Medicine, Veiga de Almeida University, Rio de Janeiro, Brazil
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7
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Powell BL, Morgan OTC. Sepsis + ptosis = an unusual diagnosis. BMJ Case Rep 2017; 2017:bcr-2017-222023. [PMID: 29070622 DOI: 10.1136/bcr-2017-222023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The authors present the case of a 19-year old man presenting to the emergency department with a 2-day history of left eye pain and ptosis, facial pain around the maxillae, coryza, headaches and fevers. He had a background of autism, mild learning disability, obsessive-compulsive disorder and asthma. Within the last month, his risperidone and sertraline doses had been increased. Basic observations and investigations suggested sepsis: tachypnoea, sinus tachycardia, fever and a raised white cell count and C reactive protein level. A CT head showed sinonasal polyposis and moderate chronic rhinosinusitis, with normal intracranial appearances. An MRI head showed evidence of extension of frontal sinus infection through the posterior wall of the left frontal sinus with subsequent left frontal extradural empyema. Intravenous antibiotics and surgical drainage of the left frontal sinus resulted in clinical improvement and discharge to complete the course of antibiotics in the community.
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Affiliation(s)
- Brooke Leigh Powell
- Department of Anaesthetics, Nottingham City Hospital, Nottingham, UK.,Emergency Department, Queen's Medical Centre, Nottingham, UK
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8
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Sireci F, Speciale R, Gallina S, Sorrentino R, Canevari FR. Clarithromycin in the Management of Chronic Rhinosinusitis: Preliminary Results of a Possible Its New Use. Indian J Otolaryngol Head Neck Surg 2017; 70:87-91. [PMID: 29456949 DOI: 10.1007/s12070-017-1153-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 07/17/2017] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with saline solution and steroid sprays (beclomethasone). During follow-up, after 30-40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of nasal obstruction; reduction/loss of smell; headache; onset of viscous secretions and therefore all patients continued therapy with saline nasal irrigation, topical steroid therapy and started macrolide (clarithromycin 500 mg/pill: 1 pill/day for 3 days a week for 1 month). 22-item SinoNasal Outcome Test (SNOT-22) and a score to the endoscopic evaluation (endoscopic appearance score, EAS) before and after treatment were performed to evaluate efficacy of treatment. The results of the SNOT-22 and EAS showed statistically significant improvements (p < 0.05) for some parameters such as: the need to blow nose, sneezing, hyposmia, viscous mucous secretions about the SNOT-22 and reduction of secretions and edema of the nasal mucosa about the EAS. The preliminary results of our study show that the low-dose clarithromycin for a period of 1 month can improve patient complaints with CRSwP not only through the antibacterial properties but also for the immunomodulatory characteristics.
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Affiliation(s)
- F Sireci
- 1Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences, (BioNeC), University of Palermo, via del Vespro 129, 90127 Palermo, Italy
| | - R Speciale
- 1Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences, (BioNeC), University of Palermo, via del Vespro 129, 90127 Palermo, Italy
| | - S Gallina
- 1Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences, (BioNeC), University of Palermo, via del Vespro 129, 90127 Palermo, Italy
| | - R Sorrentino
- Otorinolaryngology Section, SS Antonio Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - F R Canevari
- Otorinolaryngology Section, SS Antonio Biagio e Cesare Arrigo Hospital, Alessandria, Italy
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9
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Sireci F, Nicolotti M, Battaglia P, Sorrentino R, Castelnuovo P, Canevari FR. Canine fossa puncture in endoscopic sinus surgery: report of two cases. Braz J Otorhinolaryngol 2017; 83:594-599. [PMID: 28400177 PMCID: PMC9444727 DOI: 10.1016/j.bjorl.2017.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/29/2017] [Accepted: 03/01/2017] [Indexed: 11/17/2022] Open
Abstract
Introduction Chronic rhinosinusitis with nasal polyposis is a common chronic disease that often affects maxillary sinus. Endoscopic sinus surgery is the most common procedure for treating the majority of maxillary sinus lesions. Objective To demonstrate the role of canine fossa puncture during endoscopic sinus surgery procedure in patients with severe maxillary sinus disease. Methods We present 2 cases where canine fossa puncture has been performed as method to obtain a complete access to the maxillary antrum. Results According our experience, 2 cases on 296 endoscopic sinus surgery (0.6%) where antrostomy and used of angled microdebrider were not sufficient, canine fossa puncture has been performed as an alternative method to obtain a complete access to the maxillary antrum. Conclusion Although the advent of endoscopic sinus surgery, our cases support the fact that actually canine fossa puncture is a minimally invasive technique useful in selected cases.
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Affiliation(s)
- Federico Sireci
- University of Palermo, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), Otorhinolaryngology Section, Palermo, Italy.
| | - Matteo Nicolotti
- SS Antonio Biagio e Cesare Arrigo Hospital, Otorinolaryngology Section, Alessandria, Italy
| | - Paolo Battaglia
- University of Insubria, Department of Otorhinolaryngology, Varese, Italy
| | - Raffaele Sorrentino
- SS Antonio Biagio e Cesare Arrigo Hospital, Otorinolaryngology Section, Alessandria, Italy
| | - Paolo Castelnuovo
- University of Insubria, Department of Otorhinolaryngology, Varese, Italy
| | - Frank Rikki Canevari
- SS Antonio Biagio e Cesare Arrigo Hospital, Otorinolaryngology Section, Alessandria, Italy
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Hong P, Pereyra CA, Guo U, Breslin A, Melville L. Evaluating Complications of Chronic Sinusitis. Case Rep Emerg Med 2017; 2017:8743828. [PMID: 28163938 PMCID: PMC5253506 DOI: 10.1155/2017/8743828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 11/30/2016] [Indexed: 11/18/2022] Open
Abstract
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness. After further investigation he was diagnosed with a mixed anaerobic epidural abscess. The evaluation and management of chronic sinusitis are based on the presence of symptoms concerning for complication. Prompt investigation of complicated sinusitis is essential in preventing debilitating and fatal sequelae. Our case study underscores the importance of early diagnosis and appropriate management.
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Affiliation(s)
- Phillip Hong
- Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA
| | - Charles A. Pereyra
- Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA
| | - Uta Guo
- Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA
| | - Adam Breslin
- School of Medicine, St. George's University, West Indies, Grenada
| | - Laura Melville
- Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY, USA
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Benevides GN, Salgado GA, Ferreira CR, Felipe-Silva A, Gilio AE. Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome. AUTOPSY AND CASE REPORTS 2015; 5:19-26. [PMID: 26894042 PMCID: PMC4757916 DOI: 10.4322/acr.2015.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 11/07/2015] [Indexed: 12/28/2022] Open
Abstract
The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case.
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Affiliation(s)
| | - German Alcoba Salgado
- Department of Pathology - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil
| | - Cristiane Rúbia Ferreira
- Anatomic Pathology Division - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
| | - Aloísio Felipe-Silva
- Department of Pathology - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.; Anatomic Pathology Division - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
| | - Alfredo Elias Gilio
- Department of Pediatrics - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil.; Division of Pediatrics - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil
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