Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome

Authors

  • Gabriel Núncio Benevides University of São Paulo. Faculty of Medicine. Department of Pediatrics
  • German Alcoba Salgado Jr University of São Paulo. Faculty of Medicine. Department of Pathology
  • Cristiane Rúbia Ferreira University of São Paulo. Hospital Universitário. Anatomic Pathology Division
  • Aloísio Felipe-Silva University of São Paulo. Faculty of Medicine. Department of Pathology - University of São Paulo. Hospital Universitário. Anatomic Pathology Division
  • Alfredo Elias Gilio University of São Paulo. Faculty of Medicine. Department of Pediatrics - University of São Paulo. Hospital Universitário. Division of Pediatrics

DOI:

https://doi.org/10.4322/acr.2015.029

Keywords:

Sinusitis, Empyema, Subdural, Meningoencephalitis, Adolescent

Abstract

The symptoms of a previously healthy 14-year-old female with an initial history of tooth pain and swelling of the left maxillary evolved to a progressive headache and altered neurological findings characterized by auditory hallucinations, sleep disturbances, and aggressiveness. She was brought to the emergency department after 21 days of the initial symptoms. An initial computed tomography (CT) scan showed frontal subdural empyema with bone erosion. The symptoms continued to evolve to brain herniation 24 hours after admission. A second CT scan showed a left internal jugular vein thrombosis. The outcome was unfavorable and the patient died on the second day after admission. The autopsy findings depicted rarefaction of the cranial bone at the left side of the frontal sinus, and overt meningitis. The severe infection was further complicated by thrombophlebitis of the left internal jugular vein up to the superior vena cava with septic embolization to the lungs, pneumonia, and sepsis. This case report highlights the degree of severity that a trivial infection can reach. The unusual presentation of the sinusitis may have wrongly guided the approach of this unfortunate case

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Published

2015-12-10

How to Cite

Benevides, G. N., Salgado Jr, G. A., Ferreira, C. R., Felipe-Silva, A., & Gilio, A. E. (2015). Bacterial sinusitis and its frightening complications: subdural empyema and Lemierre syndrome. Autopsy and Case Reports, 5(4), 19-26. https://doi.org/10.4322/acr.2015.029

Issue

Section

Article / Autopsy Case Report