Plaza Mayor G, Pérez Martínez C, Martínez San Millán J, Denia Lafuente A
Departamento de ORL, Hospital Ramón y Cajal, Madrid.
Acta Otorrinolaringol Esp. 1998 Nov-Dec;49(8):658-62.
Intracranial complications of sinusitis now are unusual and subdural empyema is even more infrequent. Furthermore, subdural empyema usually is related to sinus infections, particularly those caused by Streptococcus milleri, an anaerobic organism. Although clinical suspicion is fundamental, computed tomography and magnetic resonance imaging are essential for discovering these complications. These studies enable early diagnosis and prompt treatment, thus reducing the high mortality of this disease. We report two cases of subdural empyema secondary to sinusitis in persons without impaired immunity. Streptococcus milleri was isolated in one of them. A review of the literature disclosed that this is the most frequently involved organism, so the empirical selection of antibiotics targeted this organism.
鼻窦炎的颅内并发症如今已不常见，硬膜下积脓则更为罕见。此外，硬膜下积脓通常与鼻窦感染相关，尤其是由米勒链球菌（一种厌氧菌）引起的感染。尽管临床怀疑至关重要，但计算机断层扫描和磁共振成像对于发现这些并发症必不可少。这些检查有助于早期诊断和及时治疗，从而降低该病的高死亡率。我们报告两例无免疫功能受损患者继发于鼻窦炎的硬膜下积脓病例。其中一例分离出了米勒链球菌。文献回顾显示，这是最常涉及的病原体，因此经验性选择针对该病原体的抗生素。
