Concomitant bilateral orbital and brain abscesses--unusual complications of pediatric rhinosinusitis.
Rhinosinusitis is a common medical problem. Complications involving the orbits or brain are not frequently met. Concomitant involvement of both orbits and the brain is very rare. We here describe a 6-year-old girl who suffered from acute rhinosinusitis and initially, subperiosteal abscesses in both orbits. Bilateral functional endoscopic sinus surgery and drainage of the subperiosteal abscesses through the upper eyelids were done. Pus cultures showed methicillin-resistant Staphylococcus aureus. The brain abscesses were found under magnetic resonance imaging (MRI) and were treated conservatively with vancomycin and rifampin for 7 weeks. The patient was free of ouular and necurologic sequelae at the 1-year follow up. Retrograde thrombophlebitis instead of anatomic dehiscence was the most likely route for the spread of infection. Multidisciplinary approaches are necessary in managing ophthalmologic and intracranial complications of sinusitis.
Huang
Shiang-Fu
SF
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei.
Lee
Ta-Jen
TJ
Lin
Kuang-Lin
KL
D000038:Abscess / Q000209:etiology* / Q000628:therapy; D001922:Brain Abscess / Q000209:etiology* / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D009916:Orbital Diseases / Q000209:etiology* / Q000628:therapy; D012220:Rhinitis / Q000150:complications*; D012852:Sinusitis / Q000150:complications*