Department of Surgery, College of Medicine, Mustansiriyah University, Baghdad, Iraq.
J Pak Med Assoc. 2021 Dec;71(Suppl 8)(12):S170-S173.
Acute sinusitis is a frequent medical condition that can affect any age group and may lead infrequently to very serious life-threatening complications. These complications include the spread of infection to frontal and other cranial bones, meninges, and other intracranial structures that require urgent medical actions to prevent mortality and morbidity. We report the case of acute frontal sinusitis in a 14 years old male who presented with fever, severe headache, and fluctuant swelling of the nasal root, and right supraorbital and frontoparietal regions. Imaging studies demonstrated signs of left-sided sinusitis, osteomyelitis of the frontal bones, and right parietal bone. Urgent surgery was performed with drainage of the abscesses and samples were sent for culture and sensitivity. Bilateral antral washout and trephination of the left frontal sinus was performed and pus was evacuated. Growth of Staphylococcus aureus and Peptostreptococcus micros was reported and according to the sensitivity report, the patient was kept on intravenous meropenem, 1500 mg per day and vancomycin 1500 mg per day was added on the 7th postoperative day. The patient was discharged from the hospital in good health on the 25th postoperative day and kept on oral vancomycin for one month.
急性鼻窦炎是一种常见的医学病症,可影响任何年龄段,极少数情况下会导致非常严重的危及生命的并发症。这些并发症包括感染扩散至额骨和其他颅骨、脑膜以及其他颅内结构,需要采取紧急医疗措施以预防死亡率和发病率。我们报告了一例 14 岁男性急性额窦炎的病例,该患者表现为发热、剧烈头痛以及鼻根、右眼眶上和额顶区域波动性肿胀。影像学研究显示左侧鼻窦炎、额骨骨髓炎和右侧顶骨的征象。紧急手术进行了脓肿引流,并送检样本进行培养和药敏试验。进行了双侧额窦冲洗和左侧额窦开窗术,并排出了脓液。报告了金黄色葡萄球菌和微小球菌的生长,根据药敏报告,患者每天接受静脉注射美罗培南 1500 毫克,并在术后第 7 天加用万古霉素 1500 毫克。患者在术后第 25 天健康出院,并继续口服万古霉素一个月。