2014, Number 4
Complicated ethmoiditis with orbital cellulitis in a nursling
Language: Spanish
References: 12
Page: 521-528
PDF size: 141.51 Kb.
ABSTRACT
Ethmoiditis is the inflammation and infection of the ethmoidal cell mucus. It is clinically diagnosed after observing edema in the medial angle of the eye extending into the adjacent structures. Imaging studies are required to verify complications such as orbital, subperiostic, epidural, subdural, cerebral abscess; thrombophlebitis of the cavernous sinus, meningoencephalitis and finally death of the patient. Streptococcus pneumoniae, Staphylococcus aureus and Haemophilus influenzae are frequently responsible for this health picture. The orbital complications seen in ethmoiditis require early diagnosis and treatment to avoid irreversible sequelae. This is the case of a male nursling aged one month and 26 days, who was admitted to the hospital with fever, rhinorrea serosa and rejection to feeding. As his condition progresses, it was observed that he presented with marked nasal obstruction, left periorbital edema, blushing, heat, eyeball protusion and irritability. He was finally diagnosed as complicated ethmoiditis with orbital cellulitis case. Computer axial tomography revealed left ethmoidal sinus filled with fluid content having cellularity rate of 15-25 UH, thickening of soft parts of the internal wall of the orbit that juts out, compresses and shifts the orbital musculature and extends into the eyebrow and to the left wing of the nose, thus deviating the soft septum in addition to slight proptosis and reduction of the bone density of the internal wall of the orbital cavity. A sample was taken for culturing, which resulted in isolation of methicillin-resistant Staphylococcus aureus. The diagnostic elements and the treatment of this disease were explained in order to call the pediatricians´attention to timely diagnose and treat these patients.REFERENCES
La Orden E, Ruiz N, Blázquez JA, Prados M, Martín MD, Ramos JT. Revisión de celulitis periorbitaria y orbitaria. Experiencia de quince años. Rev Pediatr Aten Primaria [serie en Internet]. 2009 [citado 10 de junio de 2014];11(44).Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1139- 76322009000500005&lng=en&nrm=iso&tlng=en
Pérez MG, Castro G, Mansillac C, Kaldzielskib C, Salas G, Rosanovaa MT, et al. Celulitis orbitaria neonatal por Staphylococcus aureus meticilinorresistente de la comunidad. Arch Argent Pediatr [serie en Internet]. 2013 [citado 10 de junio de 2014];110(1). Disponible en: http://dx.doi.org/10.5546/aap.2013.e50odettepp@infomed.sld.cu