Harano Momotaro, Tanaka Shiori, Inomata Kohei, Naito Shoji, Yokoi Hidenori
Department of Otolaryngology, Kyorin University Suginami Hospital, Tokyo, Japan.
Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Case Rep Otolaryngol. 2025 Aug 17;2025:7328742. doi: 10.1155/crot/7328742. eCollection 2025.
We report a case of sphenoiditis with an epidural abscess due to a fungal infection and a mixed infection with and and its clinical course, including a literature review. The patient was a 60-year-old woman who visited the emergency department of our hospital with complaints of a sudden right-sided headache that had persisted for 5 days and vomiting for 1 day. She was admitted to the hospital for an examination. Blood test results indicated a strong inflammatory reaction, and a blood culture revealed Gram-negative bacilli. Based on computed tomography and magnetic resonance imaging findings, right sphenoid sinus mycosis and a right-sided epidural hematoma were suspected, and therefore, endoscopic sinus surgery was performed. Thinning and pulsation of the right lateral wall of the sphenoid sinus were noted intraoperatively. The patient also had bacteremia, and the epidural hematoma was considered to be an abscess. The patient's symptoms improved postoperatively. Thus, she was discharged 20 days following the surgery after continuous administration of meropenem for the right-sided epidural abscess. Although cases of epidural abscesses due to infection of the sphenoid sinus are rare, in patients with severe headaches, the presence or absence of intracranial spread at an early stage must be considered to accurately diagnose and treat the pathology.
我们报告一例因真菌感染及与[具体病菌1]和[具体病菌2]混合感染导致的蝶窦炎伴硬膜外脓肿病例及其临床病程，包括文献综述。患者为一名60岁女性，因突发右侧头痛持续5天、呕吐1天前来我院急诊科就诊。她入院接受检查。血液检查结果显示有强烈的炎症反应，血培养发现革兰氏阴性杆菌。根据计算机断层扫描和磁共振成像结果，怀疑为右侧蝶窦霉菌病和右侧硬膜外血肿，因此进行了鼻内镜鼻窦手术。术中注意到蝶窦右侧壁变薄并有搏动。患者还患有菌血症，硬膜外血肿被认为是脓肿。患者术后症状改善。因此，在持续静脉滴注美罗培南治疗右侧硬膜外脓肿20天后，她出院了。虽然蝶窦感染导致硬膜外脓肿的病例很少见，但对于严重头痛的患者，必须考虑早期是否存在颅内扩散，以便准确诊断和治疗该病症。
