Boto Leonor Reis, Calado Cláudia, Vieira Marisa, Camilo Cristina, Abecasis Francisco, Campos Alexandre R, Correia Manuela
Unidade de Cuidados Intensivos Pediátricos, Departamento da Criança e da Família, Hospital de Santa Maria, Lisbon.
Acta Med Port. 2011 May-Jun;24(3):475-80. Epub 2011 Aug 12.
Subdural empyema is a life-threatening infection that may complicate acute sinusitis. The authors report the case of a previously healthy 10 year-old girl who presented with subdural empyema due to Gemella morbillorum after an untreated maxillary, ethmoidal and esphenoidal sinusitis. Despite immediate drainage of the empyema and underlying primary infection and treatment with broad spectrum antibiotics, she later developed frontal cerebritis and refractory intracranial hypertension, needing urgent decompressive craniectomy. She recovered gradually, maintaining to date slight right hemyparesis and aphasia. Even though it is considered a low virulence organism, G. morbillorum has been increasingly described in central nervous system infection. In this case, the prompt institution of broad spectrum antibiotics and surgical drainage, as well as the agressive treatment of complications, including decompressive craniectomy, were crucial to the patient's recovery.
硬脑膜下积脓是一种可能使急性鼻窦炎复杂化的危及生命的感染。作者报告了一例先前健康的10岁女孩的病例,该女孩在未经治疗的上颌窦、筛窦和蝶窦炎后因麻疹孪生球菌出现硬脑膜下积脓。尽管立即引流了积脓和潜在的原发性感染,并使用广谱抗生素进行治疗,但她后来发展为额叶脑炎和难治性颅内高压,需要紧急进行减压颅骨切除术。她逐渐康复,至今仍有轻微的右侧偏瘫和失语。尽管麻疹孪生球菌被认为是一种低毒力的微生物,但在中枢神经系统感染中对它的描述越来越多。在这个病例中,及时使用广谱抗生素和进行手术引流,以及积极治疗包括减压颅骨切除术在内的并发症,对患者的康复至关重要。