Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Subdural Empyema Caused by Sinusitis in a Child

부비동염이후 발생한 경막하 농양 1례

  • Byun, Jung Hee (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Hwang, In Kyung (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Park, Eun Kyung (Department of Neurosurgery, Yonsei University College of Medicine) ;
  • Kang, Ju Wan (Department of Otorhinolaryngology, Yonsei University College of Medicine) ;
  • Kim, Dong Soo (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Jang, Gwang Cheon (Department of Pediatrics, National Health Insurance Service Ilsan Hospital)
  • 변정희 (연세대학교의과대학 소아과학교실) ;
  • 황인경 (연세대학교의과대학 소아과학교실) ;
  • 박은경 (연세대학교의과대학 신경외과학교실) ;
  • 강주완 (연세대학교의과대학 이비인후과학교실) ;
  • 김동수 (연세대학교의과대학 소아과학교실) ;
  • 장광천 (국민건강보험 일산병원 소아청소년과)
  • Received : 2013.07.07
  • Accepted : 2013.12.02
  • Published : 2014.04.25
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Abstract

The current paper reports on a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy child. Sinusitis is a common and benign condition in most pediatric cases. Because of the widespread use of antibiotics, intracranial extension of pediatric sinusitis is rarely seen today; however, complications (e.g., cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema) are potentially life threatening. A 15-year-old right-handed male presented with a 3-day history of fever, headache, and left-sided palsy. Computed tomography revealed right-sided subdural empyema with right frontal sinusitis and maxillary sinusitis. A postoperative inpatient neurological consultation was requested 2 months post-surgery due to motor function deficits. The results suggested that early and accurate diagnosis of subdural empyema leads to prompt treatment and a favorable outcome for the patient.

부비동염은 흔하고 일반적으로 소아에서는 양성질환인 경우가 많다. 경험적으로 사용하고 있는 항생제로 인해 소아의 부비동염의 두 개강 내 합병증은 드물지만, 발생할 경우 생명에 위협적일 수 있다. 두 개강 내 합병증은 정맥동 혈전, 안와 합병증, 뇌수막염, 뇌수막하 농양 등이 있다. 이러한 합병증은 소아에서 심각한 예후를 보일 수 있다. 따라서 뇌수막하 농양을 초기에 정확하게 진단하여 치료를 시작하는 것이 중요하다. 저자들은, 급성 부비동염 치료 중이던 15세 남아가 3일간의 발열, 두통을 동반한 편마비 증상으로 내원하여 뇌 전산화 단층촬영에서 뇌수막하 농양으로 진단되어 항생제 투여 및 신경학적 수술로 치료된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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