[Subdural empyema complicating sinusitis].
Paranasal sinusitis complicated by subdural empyema (SDE) in a 14-year-old boy is described. He presented with fever, headache and vomiting. X-rays revealed left maxillary and bilateral frontal sinusitis. While in the emergency room he had seizures; CT-scan showed an air leak adjacent to the right frontal sinus. Despite intravenous antibiotics, left hemiparesis developed and repeat CT showed interhemispheric SDE. Frontal craniotomy was performed and a large amount of purulent material was drained. Recovery followed 4 weeks of intravenous antibiotic treatment without neurologic sequelae. SDE is a rare complication of paranasal sinusitis and constitutes approximately 20% of all localized intracranial infections. Clinical features include fever, headache, vomiting, convulsions and neurologic deficits. Modern imaging methods and combined surgical and antibiotic treatment have lowered mortality to 5-10%. A high index of suspicion is important for early diagnosis and successful treatment.
Saiag
E
E
Medical Corps, Israel Defence Forces.
Steir
D
D
Michowitz
M
M
Horev
G
G
Garty
B
B
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013354:Empyema, Subdural / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D012852:Sinusitis / Q000150:complications*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents