Complicated acute rhinosinusitis – a case report
Authors:
J. Kastner 1; J. Bouček 1; M. Taudy 1; J. Lisý 2; J. Betka 1
Authors place of work:
Univerzita Karlova, Praha
; Klinika otorinolaryngologie a chirurgie hlavy a krku 1. LF UK
Katedra otorinolaryngologie IPVZ, FN Motol, Praha
Přednosta: prof. MUDr. Jan Betka, DrSc.
1; Klinika zobrazovacích metod 2. LF UK, FN Motol, Praha
Přednosta: doc. MUDr. Miloslav Roček, CSc.
2
Published in the journal:
Prakt. Lék. 2009; 89(12): 689-691
Category:
Case Report
Summary
Consequent orbital and intracranial complications of acute rhinosinusitis are rare but must be mutually excluded in complicated rhinosinusitis even when proper surgical and medical treatment tend to efficiently heal the orbital complication. We report a case of a patient who primarily showed symptoms of orbitocellulitis as a complication of odontogenous rhinosinusitis. Proper diagnostic and therapeutical measures were undertaken to manage the disease immediately after admission to hospital. Two weeks after an uneventful healing period, hemiparesis developed due to the formation of an intracranial abscess. This unexpected and serious complication was inconsistent with the actual clinical course. The possible underlying mechanisms of intracranial abscess formation is discussed. The correct indication of imaging methods and accurate evaluation of diminutive symptoms are essential. We suggest that a complementary CT of the brain, or MRI, be performed, even when a previous CT scan of the orbit/paranasal sinuses has revealed no cerebral pathology, to avoid or minimize consecutive orbital and intracranial complications of acute rhinosinusitis.
Key words:
acute rhinosinusitis, intracranial complication, orbitocellulitis, endoscopic drainage, odontogenous.
Zdroje
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