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Arquivos Internacionais de Otorrinolaringologia 2011; 15(02): 241-244
DOI: 10.1590/S1809-48722011000200018
Case Report
Thieme Publicações Ltda Rio de Janeiro, Brazil

Orbital and Intracranial Complication Resulting from Acute Rhinosinusitis: Case Report

Complicação Orbital e Intracraniana Devido à Rinossinusite Aguda: Relato de Caso
Luana Alves de Souza
*   Resident Otorhinolaryngologist Doctor at Professor Edgard Santos University Hospital – UFBA – 2nd year.
,
Raquel Crisostomo Lima Verde
*   Resident Otorhinolaryngologist Doctor at Professor Edgard Santos University Hospital – UFBA – 2nd year.
,
Bruno Farias Lessa
**   Resident Otorhinolaryngologist Doctor at Professor Edgard Santos University Hospital – UFBA – 3rd year.
,
Clara Mônica Figueiredo de Lima
***   Otorhinolaryngologist Doctor.
,
Marcus Miranda Lessa
****   Doctor, Otorhinolaryngologist Doctor. Member researcher at Professor Edgard Santos University Hospital – UFBA's Otorhinolaryngology and Immunology Department.
,
Helio Andrade Lessa
*****   Doctor, Otorhinolaryngologist Doctor. Professor and Head of Professor Edgard Santos University Hospital's Otorhinolaryngology Department.
› Author Affiliations
Further Information

Publication History

06 August 2009

14 December 2009

Publication Date:
12 February 2014 (online)

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Summary

Introduction: Among the rhinosinusitis complications, the orbital are the most frequent ones, occurring mostly in the youngsters and children. Simultaneous complications involving the intracranial orbit and space are extremely rare, but they must be severely treated for they have a high rate of morbidity and mortality.

Case report: In this work, the authors report a case of a patient who appeared to have preseptal cellulites and epidural abscess, in the form of simultaneous complications of an acute rhinosinusitis. In the patient of this case, choice was made for a clinic treatment associated with a nasosinusal endoscopic surgery and neurosurgical drainage of the intracranial abscess. CT was enough to achieve the diagnosis of this case.

Final commentaries: However, it is recommended that, in cases where patients have rhinosinusitis complications, an extensive intracranial investigation needs to be deepened even when this is not so evident in the beginning. Given the polymicrobial nature of these infections, an aggressive culture-guided antibiotic therapy and a multidisciplinary follow-up significantly increase the likelihood of success.

Resumo

Introdução: Dentre as complicações da rinossinusite, as orbitárias são as mais frequentes, e estas, ocorrem na maioria dos casos entre jovens e crianças. Complicações simultâneas envolvendo a órbita e o espaço intracraniano são extremamente raras, mas devem ser tratadas agressivamente pois oferecem alta taxa de morbidade e mortalidade.

Relato do Caso: Neste trabalho, os autores relatam um caso de um paciente que se apresentou com celulite pré-septal e abscesso epidural, como complicações simultâneas de uma rinossinusite aguda. No paciente deste estudo, optou-se pelo tratamento clínico associado à cirurgia endoscópica nasossinusal e drenagem neurocirúrgica do abscesso intracraniano. A TC foi suficiente no caso apresentado para a realização do diagnóstico.

Comentários Finais: Recomenda-se entretanto, que nos casos de pacientes com complicações da rinossinusite, a investigação da extensão intracraniana seja aprofundada, mesmo quando esta, a princípio não seja tão evidente. Dada a natureza polimicrobiana dessas infecções, uma antibioticoterapia agressiva guiada por cultura e um acompanhamento por equipe multidisciplinar, aumentam consideravelmente as chances de sucesso.

Keywords

orbital cellulites - sinusitis - epidural abscess

Palavras-chave

celulite orbitária - sinusite - abscesso epidural
 

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