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小儿耳源性脑静脉窦血栓形成:病例报告及文献复习。

Pediatric otogenic cerebral venous sinus thrombosis: a case report and a literature review.

机构信息

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Paediatric Emergency Department, Milan, Italy.

University of Milan, Milan, Italy.

出版信息

Ital J Pediatr. 2020 Sep 3;46(1):122. doi: 10.1186/s13052-020-00882-9.

Abstract

BACKGROUND

Cerebral venous sinus thrombosis in children is a rare but potentially fatal complication of acute mastoiditis, one of the most common pediatric infectious diseases. Due to its subtle clinical presentation, suspicion is essential for a prompt diagnosis and appropriate management. Unfortunately, no standard treatment options are available. To discuss the possible clinical presentation, microbiology, and management, we here report the case of a child with otogenic cerebral venous sinus thrombosis and perform a literature review starting from 2011.

CASE PRESENTATION

The child, a 10-months-old male, presented clinical signs of right acute otitis media and mastoiditis. Brain computed tomography scan detected right sigmoid and transverse sinus thrombosis, as well as a subperiosteal abscess. Fusobacterium necrophorum and Haemophilus Influentiae were detected on cultural sampling. A multidisciplinary approach along with a combination of medical and surgical therapy allowed the patient's full recovery.

CONCLUSION

Cerebral venous sinus thrombosis is a rare but severe complication of acute otitis media and mastoiditis. The management of this pathological condition is always challenging and an interdisciplinary approach is frequently required. Current therapeutic options include a combination of medical and surgical therapy. A patient-centered approach should guide timing and treatment management.

摘要

背景

儿童脑静脉窦血栓形成是急性乳突炎的一种罕见但潜在致命的并发症,急性乳突炎是最常见的儿科传染病之一。由于其微妙的临床表现,及时诊断和适当治疗至关重要。不幸的是,目前尚无标准的治疗选择。为了讨论可能的临床表现、微生物学和治疗方法,我们在此报告一例由耳源性脑静脉窦血栓形成的患儿病例,并从 2011 年开始进行文献复习。

病例介绍

患儿,10 个月男童,表现出右侧急性中耳炎和乳突炎的临床症状。脑计算机断层扫描显示右侧乙状窦和横窦血栓形成,以及骨膜下脓肿。培养标本检测到坏死梭杆菌和流感嗜血杆菌。多学科方法结合药物和手术治疗使患者完全康复。

结论

脑静脉窦血栓形成是急性中耳炎和乳突炎的罕见但严重的并发症。这种病理情况的治疗一直具有挑战性,通常需要多学科方法。目前的治疗选择包括药物和手术治疗的联合应用。以患者为中心的方法应指导治疗时机和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8d6/7470606/6eec0aada7fe/13052_2020_882_Fig1_HTML.jpg

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