12岁儿童放线菌性急性鼻窦炎并发骨膜下脓肿:病例报告及文献复习

IF 0.4 Q4 OTORHINOLARYNGOLOGY Case Reports in Otolaryngology Pub Date : 2022-04-11 DOI:10.1155/2022/7058653
S. Nimmagadda, Li-Xing Man, Margo K McKenna, J. Faria, I. Schmale
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引用次数: 1

摘要

目的报道1例罕见的小儿放线菌性鼻窦炎合并眼眶骨膜下脓肿病例,回顾文献资料,探讨其诊断、治疗方法及治疗效果。方法结合病例报告和文献复习。结果1例12岁的克罗恩病患者接受英夫利昔单抗治疗后表现为鼻窦炎伴眶骨膜下脓肿形成。内镜下鼻窦手术,培养出放线菌。开始了一个延长疗程的抗生素治疗,导致感染完全消失。在一篇文献综述中,所有简单和复杂放线菌性鼻窦炎的病例都通过适当的手术和长期的抗生素治疗而治愈。我们的病例是第一例报道的儿科患者,也是第一例服用免疫抑制药物的患者。总体而言,仅报道了3例免疫抑制个体的放线菌性鼻窦炎,每个人都有不受控制的糖尿病,每个人都对手术和适当的抗生素反应良好。结论鼻窦放线菌病的诊断具有挑战性,其感染在表现和疾病程度上差异很大。高度的怀疑指数、适当的检测和早期积极治疗对于管理这种感染的患者至关重要。我们的病例和先前发表的研究表明,放线菌性鼻窦炎可以通过内镜鼻窦手术、必要时脓肿引流和延长抗生素疗程来成功治疗,即使在免疫功能低下和儿童人群中也是如此。
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Actinomyces Acute Rhinosinusitis Complicated by Subperiosteal Abscess in an Immunocompromised 12-Year-Old: Case Report and Literature Review
Objective To describe a rare case of pediatric actinomycotic rhinosinusitis with orbital subperiosteal abscess and review the current literature to assess methods of diagnosis, treatment modalities, and outcomes with appropriate treatment. Methods A case report and a review of the literature. Results A 12-year-old patient with Crohn's disease on infliximab presented with rhinosinusitis with orbital subperiosteal abscess formation. Endoscopic sinus surgery was performed and cultures grew actinomyces. A prolonged course of antibiotics was started, resulting in the complete resolution of the infection. In a literature review, all cases of uncomplicated and complicated actinomyces rhinosinusitis managed with appropriate surgery and prolonged antibiotics resulted in a cure. Our case is the first reported in a pediatric patient and the first taking immunosuppressive medication. Overall, only 3 cases of actinomyces rhinosinusitis in immunosuppressed individuals have been reported, each with uncontrolled diabetes and each also responded well to surgery and appropriate antibiotics. Conclusion Actinomycosis of the paranasal sinuses poses a diagnostic challenge, with infections varying widely in presentation and extent of disease. A high index of suspicion, appropriate testing, and early aggressive treatment are critical in managing patients with this infection. Our case and prior published studies show that actinomyces rhinosinusitis can be successfully managed with endoscopic sinus surgery, abscess drainage as necessary, and a prolonged course of antibiotics, even in immunocompromised and pediatric populations.
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Case Reports in Otolaryngology
Case Reports in Otolaryngology OTORHINOLARYNGOLOGY-
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审稿时长
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