cefotaxime and Mucocele

In cystic fibrosis (CF) patients, Ear Nose Throat (ENT) pathology is often undiagnosed despite its high prevalence and its possible life-threatening complications. We present the case of an ethmoidal mucocele leading to ocular manifestations in a 2-year-old girl with cystic fibrosis with no previous serious complications. She progressively developed non-axial proptosis, limitation of the adduction and exotropia of her left eye. Paranasal sinus magnetic resonance image (MRI) showed a left ethmoidal mucocele causing displacement of the ocular globe, compression of the medial rectus and the optic nerve. Eye fundus revealed disc edema and diffuse vascular congestion. Endoscopic sinus surgery was performed to remove the mass. The mucocele was drained and the discharge was sent for microbiology assessment. Escherichia coli (E. coli) was found in the culture and treated with cefotaxime and dexamethasone with complete resolution of non-axial proptosis and disc edema.

Topics: Cefotaxime; Child; Child, Preschool; Cystic Fibrosis; Dexamethasone; Escherichia coli; Ethmoid Sinus; Exophthalmos; Female; Humans; Mucocele; Paranasal Sinus Diseases

Periorbital infection following pansinusitis is a rare complication which can lead to irreversible orbital and intracranial consequences. Chandler classified them in 1970.. An eight-year-old child presented with a subperiosteal superolateral abscess. The initial flu-like syndrome developed into pansinusitis resisting to usual treatment. Palpebral edema and major exophthalmia then appeared requiring CT scan and MRI, which confirmed a subperiosteal abscess.. A subperiosteal abscess is a serious condition requiring an early diagnosis and a medical or surgical treatment adapted to the severity. Chandler's classification gives the opportunity to adapt management to the infection's gravity. Ethmoiditis may be complicated by periorbital abscesses found usually in the superointernal quadrant. Medical imaging and surgical treatment confirmed a superolateral periorbital abscess and a frontal mucocele. This case illustrates the possibility of communication between frontal sinus and orbital cavity. During frontal sinus infection, pre-existing mucocele may become super-infected and induce a periorbital abscess.

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Drainage; Drug Combinations; Exophthalmos; Frontal Sinusitis; Humans; Magnetic Resonance Imaging; Male; Metronidazole; Mucocele; Orbital Cellulitis; Radiography; Vancomycin