[Papilledema and acute bilateral amaurosis accompanying acute sinusitis].
BACKGROUND
Acute sinusitis can lead to severe complications. This includes involvement of the optical nerve with visual loss and brain abscess as a life-threatening complication.


METHODS
Empyema of the chiasma opticum region with neuritis nervi optici and bilateral acute amaurosis was observed in a 13 year old boy with sinusitis sphenoidalis and ethmoidalis. In a 11 year old girl, pronounced papilledema was found to be closely associated with sinusitis sphenoidalis. While she recovered completely on appropriate antibiotic therapy, visual loss in the boy was irreversible despite surgical intervention.


CONCLUSIONS
Sinusitis should always be considered in patients with impaired vision, neuritis nervi optici or unexplained papilledema, especially if occurring in association with an upper respiratory infection. In addition to physical examination, cranial computer tomography or magnetic resonance imaging of the brain including sinuses and chiasma opticum should be applied early. If empyema is found, immediate surgical intervention is of prognostic importance.
Jüngert
J M
JM
Klinik für Kinder und Jugendliche der Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany.
Uberall
M
M
Mayer
U M
UM
Guggenbichler
J P
JP
Heininger
U
U
D000208:Acute Disease; D000293:Adolescent; D001766:Blindness / Q000209:etiology*; D002648:Child; D004653:Empyema / Q000175:diagnosis; D005005:Ethmoid Sinus / Q000473:pathology; D015521:Ethmoid Sinusitis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009887:Ophthalmoscopy; D009902:Optic Neuritis / Q000175:diagnosis; D010211:Papilledema / Q000209:etiology*; D011379:Prognosis; D013101:Sphenoid Sinus / Q000473:pathology; D015524:Sphenoid Sinusitis / Q000175:diagnosis*; D014792:Visual Acuity / Q000502:physiology