cefotaxime and Ethmoid-Sinusitis

The authors report on an 8-year-old girl who experienced bilateral subdural frontoparietal and interhemispheric empyema following sinusitis. The child improved after initial treatment with a 3 weeks course of parenteral antibiotics. Surgical drainage was further required because of clinical aggravation; however, this evolution was related to bilateral frontoparietal brain edema and abscesses fluid was sterile.

Topics: Brain Edema; Cefotaxime; Child; Drainage; Drug Therapy, Combination; Empyema, Subdural; Ethmoid Sinusitis; Female; Follow-Up Studies; Fosfomycin; Humans; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Trephining

A 29-year-old woman, who was diagnosed as Crouzon syndrome for which two cranio-facial surgeries had been performed as a child and at the age of 19, developed high fever, headache, and confusion for two days. She was admitted to our hospital. She was diagnosed as bacterial meningitis by cerebrospinal fluid examinations, and her condition was immediately improved by antibiotics. At the age of 23, she also suffered from bacterial meningitis caused by otitis media and sinusitis, and recovered by antibiotics with no sequela. Her cranial computed tomography showed sphenoid and ethmoid sinusitis, and bone deformation and hypertrophy with no fistula connecting intracranial space and sinus. Dead space by cranio-facial surgeries might cause the development of chronic or recurrent sinusitis leading to bacterial meningitis. Our patient is the second case of recurrent bacterial meningitis with Crouzon syndrome to our knowledge. We should recognize that recurrent sinusitis with Crouzon syndrome after cranio-facial surgery is a risk of recurrent meningitis.

Topics: Adult; Anti-Bacterial Agents; Cefotaxime; Craniofacial Dysostosis; Drug Therapy, Combination; Ethmoid Sinusitis; Female; Humans; Meningitis, Bacterial; Piperacillin; Plastic Surgery Procedures; Postoperative Complications; Recurrence; Treatment Outcome