Govea-Camacho LH, Pérez-Ramírez R, Palma-Paulo F, Moreno-Verdín LC, Patricio MMA, Jiménez-Sala CJ

Language: Spanish
References: 8
Page: 140-145
PDF size: 550.36 Kb.

ABSTRACT

The chronic rhinosinusitis (CSR) is defined as inflammation or infection of the nose and sinuses for 12 weeks or more, with a prevalence of 10%. Several diseases may coexist with the CRS, including asthma, aspirin sensitivity, atopy, chronic rhinitis, depression, anxiety and fatigue. Intracranial complications are rare, which have declined significantly since the advent of antibiotics. We present a case of male patient 19 years of age with allergic rhinitis since childhood in control with homeopathy, major depression since the age of 13 years, treaty by three years with escitalopram. History of chronic rhinosinusitis, which is sent after a week of evolution by presenting exacerbation of symptoms, nasal obstruction accompanied by left nostril dominance, multi-treated with antibiotics, adding five days before admission, cranial headache, fever unquantified, speak slowly, bradypsychia, right hemiparesis, slight left proptosis conjugate gaze limitation. With the suspicion of a possible neurological complications of rhinosinusitis, imaging study is performed skull and sinuses, noting RSC suggestive image of subdural empyema complicated. Surgical management was decided in conjunction with the department of neurosurgery, performing functional sinus surgery and craniotomy fronto-parietotemporal and toilet left with surgical drainage of the collection. Periodic scans are performed that show clear improvement, however with residual collection opting for intravenous antibiotics for 4 weeks. After normalization clinic the patient was discharged, with the sequels right hemiparesis 4/5.

REFERENCES

1. Myller JP, Luukkainen AT, Huhtala HS, Torkkeli TV, Rautiainen ME, Toppila-Salmi SK. Satisfaction with maxillary sinus surgery might be influenced by risk factors. Allergy Rhinol (Providence). 2013; 4 (1): e6-e12. doi: 10.2500/ar.2013.4.0039.

2. Bruner DI, Littlejohn L, Pritchard A. Subdural empyema presenting with seizure, confusion, and focal weakness. West J Emerg Med. 2012; 13 (6): 509-511.

3. Beckham D, Kenneth L. Intensive care of patients with acute CNS infections. Neuro J Neurotherapeutics. 2012; 9: 124-138.

4. Taha MM, Hassanaın S. Subtentorial subdural empyema: report of two cases and review of the literatures. West J Emerg Med. 2011; 21, No: 4: 669-673.

5. Marambaia PP, Lima MG, Santos KP, Gomes A de M, de Sousa MM, Marques ME. Evaluation of the quality of life of patients with chronic rhinosinusitis by means of the SNOT-22 questionnaire. Braz J Otorhinolaryngol. 2013; 79 (1): 54-58.

6. Cain RB, Lal D. Update on the management of chronic rhinosinusitis. Infect Drug Resist. 2013; 6: 1-14.

7. Lee SK, Kim SW. Fatal subdural empyema following pyogenic meningiti. J Korean Neurosurg Soc. 2011; 49: 175- 177.

8. Greve T, Clemmensen D, Ridderberg W, Pedersen LN, Møller JK. Polymicrobial subdural empyema: involvement of Streptococcus pneumoniae revealed by lytA PCR and antigen detection Update on the management of chronic rhinosinusitis. BMJ Case Rep. 2011; 2011. pii: bcr0920103344. doi: 10.1136/bcr.09.2010.3344.