Nallani Rohit, Price Michael E, Narayanan Srivats S, Tracy Meghan, Arganbright Jill
Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, USA.
School of Medicine, University of Missouri at Kansas City, Kansas City, USA.
Cureus. 2023 Feb 14;15(2):e34960. doi: 10.7759/cureus.34960. eCollection 2023 Feb.
Pediatric coronavirus disease 2019 (COVID-19) has been associated with various complications including chronic respiratory disease and multisystem inflammatory syndrome. There are a few reported cases of complicated sinusitis following pediatric COVID-19 infection. We present a patient with recent COVID-19 who developed complicated sinusitis with intracranial extension and Lemierre syndrome. A 16-year-old female with a history of COVID-19 diagnosis 17 days prior presented with worsening head and neck symptoms. Physical examination demonstrated left proptosis, cranial nerve (CN) VI palsy, and limited neck range of motion. Imaging demonstrated bilateral sinus disease, a 3.3 × 2 × 3-centimeter sellar/clival abscess, bilateral cavernous sinus thrombosis, and thrombosis of bilateral internal jugular veins. Urgent endoscopic sinus surgery was performed, and long-term intravenous antibiotics and anticoagulation were initiated with improvement in symptoms over three weeks. Providers caring for patients with COVID-19 should keep complicated sinusitis and Lemierre syndrome in their differential. Further study of COVID-19 pathophysiology in the sinonasal mucosa is needed.
儿童2019冠状病毒病（COVID-19）与多种并发症相关，包括慢性呼吸道疾病和多系统炎症综合征。有几例关于儿童COVID-19感染后并发鼻窦炎的报道。我们报告一例近期感染COVID-19的患者，其并发了伴有颅内扩展的鼻窦炎和勒米尔综合征。一名16岁女性，17天前确诊COVID-19，现出现头颈部症状加重。体格检查发现左侧眼球突出、第六对颅神经（CN）麻痹以及颈部活动范围受限。影像学检查显示双侧鼻窦疾病、一个3.3×2×3厘米的鞍区/斜坡脓肿、双侧海绵窦血栓形成以及双侧颈内静脉血栓形成。紧急进行了鼻内镜鼻窦手术，并开始长期静脉使用抗生素和抗凝治疗，症状在三周内有所改善。照顾COVID-19患者的医护人员应将并发鼻窦炎和勒米尔综合征列入鉴别诊断范围。需要进一步研究COVID-19在鼻窦黏膜中的病理生理学。
