Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA.
Ann Otol Rhinol Laryngol. 2022 Oct;131(10):1158-1163. doi: 10.1177/00034894211055337. Epub 2021 Oct 27.
This case report presents a case of a rapidly progressive complicated sinus infection in a child with the multisystem inflammatory syndrome in children.
Case report with literature review.
RESULTS/CASE REPORT: We present a novel case of severe rapidly progressive complicated sinusitis in a 14-year-old African American male diagnosed with the multisystem inflammatory syndrome in children. Infection was caused by an aggressive pathogen, Streptococcus intermedius (anginosus), and within 48 hours progressed to orbital, subgaleal, and intracranial abscess, requiring multidisciplinary intervention by ophthalmology, neurosurgery, and otolaryngology. Following surgical intervention and a 4-week course of intravenous antibiotic therapy, the patient had resolution of the infection with no neurologic sequelae.
Despite the low incidence of multisystem inflammatory syndrome in children, physicians should be aware that immunologic changes and the cytokine storm induced by severe acute respiratory syndrome coronavirus 2 can potentially predispose patients to severe bacterial or opportunistic infections. As more cases of MIS-C develop, associated complications can become evident. Similar cases of SARS-CoV-2 and severe bacterial sinusitis have been published in the literature, but it remains unclear if there is an association between SARS-CoV-2 disease and an increased risk of complicated sinusitis in children.
本病例报告介绍了一例儿童多系统炎症综合征并发快速进展性复杂鼻窦炎的病例。
病例报告并文献复习。
结果/病例报告：我们报告了一例 14 岁非裔美国男性儿童多系统炎症综合征并发严重快速进展性复杂鼻窦炎的新病例。感染由侵袭性病原体中间链球菌（咽峡炎链球菌）引起，48 小时内发展为眶周、皮下和颅内脓肿，需要眼科、神经外科和耳鼻喉科多学科干预。经手术干预和 4 周静脉抗生素治疗后，患者感染得到缓解，无神经后遗症。
尽管儿童多系统炎症综合征的发病率较低，但医生应意识到严重急性呼吸综合征冠状病毒 2 引起的免疫变化和细胞因子风暴可能使患者易患严重细菌或机会性感染。随着更多的 MIS-C 病例的出现，相关并发症可能会显现出来。类似的 SARS-CoV-2 和严重细菌性鼻窦炎的病例已在文献中发表，但目前尚不清楚 SARS-CoV-2 疾病与儿童复杂性鼻窦炎风险增加之间是否存在关联。
