Acute isolated sphenoid sinusitis.
BACKGROUND
Acute isolated sphenoid sinusitis is seen in fewer than 3% of all cases of sinusitis. It is frequently misdiagnosed because of its vague symptoms and the paucity of clinical findings. We report 2 cases of isolated acute isolated sphenoid sinusitis with unusual presentations.


METHODS
Both patients presented with acute headache, eye pain and fever, and were provisionally diagnosed as meningitis. In 1 case, the symptoms were on the contralateral side of the sphenoid infection. Intracranial complications were also present.


METHODS
Treatment included intravenous antibiotics and endoscopic sphenoidotomy.


RESULTS
Both patients recovered with no residual neurological disability.


CONCLUSIONS
Acute sphenoiditis usually presents with subtle symptoms and elusive physical findings and hence a high index of suspicion is necessary. Complications may arise due to the close proximity of important structures to the sphenoid sinus. Uncomplicated cases can resolve with optimal antibiotic therapy if diagnosed and treated early. Persistence or progression of disease with development of intracranial complications are indications for immediate surgical drainage.
Tan
H K K
HK
Otolaryngology Service, Division of Pediatric Surgery, KK Women and Children's Hospital, Singapore. enttankk@kkh.com.sg
Ong
Y K
YK
D000208:Acute Disease; D000328:Adult; D002648:Child; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012846:Singapore; D015524:Sphenoid Sinusitis / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology