查詢結果分析
相關文獻
- 小兒急性鼻竇炎併發硬腦膜下膿瘍--病例報告
- 顱內膿瘍:現今的處理觀念
- HELLP Syndrome with Antepartum Pulmonary Edema--A Case Report
- Ephedrine-Induced Complete Atrioventricular Block with Ventricular Asystole during Rapid Concomitant Phenytoin Infusion: A Case Report
- Epiglottic Hematoma Secondary to Endotracheal Intubation
- 臺灣地區慢性脊髓損傷病患排尿處置之調查報告
- 小兒使用TPN引起的併發症
- 淺談糖尿病及其併發症
- 難忘的病人--民俗療法之併發症
- Clinical Experience with Ventricular Endomyocardial Biopsy in Chinese Heart Transplant Patients: A Four-Year Survey of 1,208 Consecutive Procedures
頁籤選單縮合
題名 | 小兒急性鼻竇炎併發硬腦膜下膿瘍--病例報告=Acute Sinusitis Complicated by Subdural Abscess in a Child--Case Report |
---|---|
作者 | 黃麒銓; 歐俊巖; Huang, Chi-chiuan; Ou, Chun-yen; |
期刊 | 中華民國耳鼻喉科醫學雜誌 |
出版日期 | 20010700、20010800 |
卷期 | 36:4 民90.07-08 |
頁次 | 頁239-243 |
分類號 | 417.6855 |
語文 | chi |
關鍵詞 | 小兒鼻竇炎; 併發症; 顱內感染; Pediatric sinusitis; Complication; Intracranial infection; |
中文摘要 | 在鼻竇炎的併發症中,最常見的是侵犯眼球以及眼眶四周。當今由於抗生素效能增強以及被廣泛的使用,因鼻竇炎引起的顱內併發症已大為少見。然而因為臨床上的症狀以頭痛、發燒、意識狀態改變為主,同時病人多半沒有明顯的鼻部症狀,因此容易被忽略,導致延誤治療,提高了致病率及死亡率。本例病患為1名9歲肥胖男童,因發燒、頭痛持續4天而被送至本院。入院檢查時發現該男童意識狀態改變、頸部僵硬並有吐現象,加上血液檢查呈現嗜中性白血球以及C型應蛋白(CRP)明顯上升,疑似為顱內感染。經過腰椎穿刺以及頭部電腦斷層攝影檢查,發現為右側上頜竇鼻竇炎合併左側額葉區以及兩側半球間池(interhemispheric cistern)硬腦膜下膿瘍,於是病患接受鼻竇內視鏡手術以及顱部手術排膿治療。經過8週的抗生素治療,術後3個月以磁振造影追蹤,已無硬腦膜下膿瘍之現象。由此病例可知,對於懷疑有急性顱內感染的小兒病患,鼻竇炎必須列入鑑別診斷。早期影像學檢查為診斷的利器,特別是磁振造影比電腦斷層攝影會有較高的敏感度。有了早期及時的診斷,配合排膿手術適合的抗生素治療,才能有效降低死亡率並減少後遺症。 |
英文摘要 | Complications and local extension of paranasal sinus infections typically involve the orbit and periorbital areas. With the advances in and widespread use of antibiotics, intracranial sinusitis complications are rarely seen nowadays. The most frequent symptoms and signs at presentation are fever, headache, and altered consciousness, but not necessarily with nasal symptoms. Accordingly, intracranial complications are easily missed and can result in high mortality and morbidity. An obese, 9-year-ole boy was referred to our hospital with a four day history of fever and headache. On examination, altered consciousness, neck stiffness, and vomiting were apparent. Hematological analysis found elevated neutrophil counts and an increase in C-reactive protein (CRP). Intracranial infection was therefore suspected. A lumbar puncture and CT scan were performed, and right maxillary sinusitis with a subdural abscess over the left frontal lobe and interhemispheric cistern were identified. He underwent endoscopic sinus surgery and intracranial surgery for drainage. Postoperatively, he received an eight-week course of intra-venous antibiotics. Follow up magnetic resonance imaging three months later found no remnants of the subdural abscess. With or without nasal symptoms, complicated sinusitis must be included in the differential diagnosis in pediatric patients with suspected acute intracranial infections. Early imaging is a powerful diagnostic tool, and magnetic resonance imaging has a higher sensitivity than CT. Early diagnosis followed by surgical drainage and appropriate antibiotics treatment is the only effective means by which mortality and complications can be reduced. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。