[Complications of bacterial rhino-sinusitis in children: a case report and a review of the literature].
Acute sinusitis in children is a controversial issue in terms of its diagnostic criteria, classification and therapeutic management. A therapeutic delay can lead to complications if the cause is bacterial. Guidelines have been set, but they are not consensual in pediatrics. Complications of acute bacterial sinusitis are uncommon in children, but they can be extremely severe and cause high morbidity and mortality. Because of their rarity, they often are not identified early, exposing the patient to an unfavorable outcome. We report on a case of acute bacterial pan-sinusitis complicated with thrombophlebitis of the cavernous sinuses and meningitis in a 9-year-old child, in spite of early and adapted antibiotic therapy. The bacterial agent was Staphylococcus aureus, which had no resistance or toxin profile. The progression was favorable under intravenous antibiotic therapy and after bilateral sphenoidectomy. This case raises the question of the best therapy for acute bacterial sinusitis in pediatrics and the management of complications.
Service des urgences pédiatriques, hôpital d'enfants Armand-Trousseau, 75012 Paris, France. flore.amat@etu.parisdescartes.fr
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D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D020226:Cavernous Sinus Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D003131:Combined Modality Therapy; D018450:Disease Progression; D004359:Drug Therapy, Combination; D015521:Ethmoid Sinusitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013101:Sphenoid Sinus / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents