Parietal subdural empyema as complication of acute odontogenic sinusitis: a case report

Journal of Medical Case Reports

Federico Sireci³  Angelo Gambino²  Marianna Mucia¹  Sergio Ferrara³  Pietro Salvago³  Francesco Martines¹ 

[1] Audiology Section, Department of Biopathology and Medical and Forenses Biotechnologies (DiBIMEF), University of Palermo, Palermo, Italy;Radiology Section, Department of Biopathology and Medical and Forenses Biotechnologies (DiBIMEF), University of Palermo, Palermo, Italy;Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy

关键词: Subdural empyema;    Paranasal sinusitis;    Odontogenic sinusitis;    Intracranial infections;   

Others  :  1181070
DOI  :  10.1186/1752-1947-8-282

 received in 2014-04-11, accepted in 2014-06-30,  发布年份 2014

【 摘 要 】

Introduction

To date intracranial complication caused by tooth extractions are extremely rare. In particular parietal subdural empyema of odontogenic origin has not been described. A literature review is presented here to emphasize the extreme rarity of this clinical entity.

Case presentation

An 18-year-old Caucasian man with a history of dental extraction developed dysarthria, lethargy, purulent rhinorrhea, and fever. A computed tomography scan demonstrated extensive sinusitis involving maxillary sinus, anterior ethmoid and frontal sinus on the left side and a subdural fluid collection in the temporal-parietal site on the same side. He underwent vancomycin, metronidazole and meropenem therapy, and subsequently left maxillary antrostomy, and frontal and maxillary sinuses toilette by an open approach. The last clinical control done after 3 months showed a regression of all symptoms.

Conclusions

The occurrence of subdural empyema is an uncommon but possible sequela of a complicated tooth extraction. A multidisciplinary approach involving otolaryngologist, neurosurgeons, clinical microbiologist, and neuroradiologist is essential. Antibiotic therapy with surgical approach is the gold standard treatment.

【 授权许可】

   
2014 Martines et al.; licensee BioMed Central Ltd.

【 图 表 】

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