© Borgis - New Medicine 4/2012, s. 129-130
Małgorzata Dębska, *Jolanta Jadczyszyn, Lidia Zawadzka-Głos
Rare cause of subperiosteal abscess – a case report
Department of Pediatric Otolaryngology, Medical University of Warsaw
Head of Department: Lidia Zawadzka-Głos, MD, PhD
Sinusitis occurs frequently in children. Foreign bodies, inserted randomly into nasal cavities might also be the cause of sinusitis in children. In our case, the foreign body obstructing causing the maxillary and ethmoid sinusitis and further, the orbital soft tissue infection with suoeroeriosrali abscessus.
Sinusitis occurs frequently in children and is associated with recurrent infections of the upper airways, which include the nasal mucosa, and in the developing period of the air spaces of the sinuses. In small children, the most common form is the ethmoid sinusitis, unrestrainedly, with high fever, septic state and possible inflammatory reaction on the part of the orbit. Approximately 3% of the cases are affected by orbital complications in the course of sinusitis. A frequent complication arising during the process of subperiosteal abscess formation in due to the presence of innate dehiscence in the wall bones, mainly in the orbital lamina of ethmoid bone of incompletely closed sutures of the thinner bone walls (1). This condition requires intensive intravenous antibiotic therapy and surgical intervention. Orbital abscess occurs most often in the area of superior medial orbit, located between orbital lamina of ethmoid bone and the periosteum of the orbit. It is a displacement of the eye upward and laterally and eye movement disorders might be observed (2, 3).
An 11-year-old boy, with a fever lasting 3 days, left eye pain, oedema of the eyelids and the exophthalmos of the left eye, was admitted urgently to the Clinic of Pediatric Laryngology. In medical history taking the patient was hospitalized between 18-19.05.2009 in the Department of Ophthalmology, Centre for Postgraduate Education, in Warsaw because of the inflammation of the left orbital tissues. Physical examination revealed – OP – no change, OL – palperbral oedema and oedema of the orbital tissues, eyeball set in exophthalmos downward and externally, purulent discharge in the conjunctival sac, and the posterior cornea with multiple and linear epithalial defects, without evidence of inflammation in anterior part. The X-ray showed total shading of the left maxillary sinuses, poorly visible edge of the left eye socket, paranasal sinuses unchanged. Sol. Oftaquix, ung. Gentamycini was incorporated for local treatment. After consulting ENT biotraxon was included in the intravenous treatment of sinusitis, and the patient was transferred to the Clinic of Pediatric Otolaryngology. Upon admission to the hospital the boy in generally average condition, suffering, somnolent, complained of pain in the area of the left eye socket increasing when trying to verticalize. On physical examination, oedema of the eyelids and tissues of the left eye socket, eyeball set in exophthalmos, a large amount of abscess discharge in the conjunctival sac.
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zaakceptowano do druku: 2012-10-31
Adres do korespondencji:
Department of Pediatric Otolaryngology Medical University of Warsaw
24 Marszałkowska St., 00-576 Warsaw
tel./fax: +48 (22) 628-05-84
e-mail: email@example.comNew Medicine 4/2012
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