Suppurative Complications of Frontal Sinusitis in Children

Abstract

A retrospective review of children diagnosed and treated for suppurative complications of paranasal sinusitis was undertaken to describe clinical presentation, microbiology, and treatment. This review includes children with subgaleal abscess and osteomyelitis of the frontal bone, subdural empyema, frontal lobe abscess, meningitis, and encephalitis. Staphylococcus aureus and group C beta-hemolytic Streptococcus were isolated agents. All children were treated with intravenous antibiotics with drainage of both the sinus and extracranial and intracranial suppurations. Results of treatment in the series support the opinion that combined aggressive surgical and antibiotic treatment is a preferred method in complicated sinusitis in children.

Two Case Reports of Antrorhinoliths

“…These include the entry and impaction of a foreign body in the nasal cavity, acute and chronic inflammation, obstruction and stagnation of the nasal secretions and precipitations of mineral salts. 5 These nidi may be endogenous or exogenous. 6 Our first case of antrorhinolith which was formed after endoscopic sinus surgery.…”

Microbiology and antimicrobial treatment of orbital and intracranial complications of sinusitis in children and their management

“…The other route of extension is through the valveless venous system that interconnects the intracranial venous system with the sinus mucosal vasculature [17]. Thrombophlebitis that originates in the sinus mucosal veins can progress through this network to the emissary skull veins, dural venous sinuses, subdural veins, and cerebral veins.…”

“…Abscesses in the deeper white matter are less vascular than those in the cortex, their walls are thinnest when they are near the ventricle, and they often rupture into the ventricular system. Accumulation of SE occurs at four distinct sites [16][17][18][19]. The pus can form over the frontal parietal convexity, and can be located focally anywhere, but mostly over the frontal pole and occipital complex, or under the posterior fossa tentorium.…”

“…[15]. Microaerophilic streptococci are also very common, and can be isolated from abscesses caused by maxillary sinusitis that originates from dental infection of the upper jaw [17]. The most common aerobe is S. aureus, and H. influenzae is rarely isolated.…”

FatalStreptococcus canisInfections in Intensively Housed Shelter Cats

“…In humans, Streptocccus is a common organism isolated in cases of acute suppurative sinusitis with complications, 1 of which is meningitis. 5,7 In these cats, meningitis was considered sequelae to frontal sinusitis based on histologic evidence of inflammation and boney remodeling within the cribriform and frontal bone plates. Although other pathogens were detected in the nasal cavity of some cats, none was detected consistently, and all were well within the limits of normal incidence for a shelter environment.…”