TITLE:
Endocranial Suppurations of Sinus Origin: Ratio of 3 Cases in Children at the Hospital in Mali
AUTHORS:
Bourama Kané, Korotoumou Wélé Diallo, Mohamed Maba Traoré, Boubacar Mami Touré, Mahamadou Dama, Mody Abdoulaye Camara, Guédiouma Dembélé, Daouda Sissoko, Oumar Coulibaly, Mamadou Traoré
KEYWORDS:
Sinusitis, Endocranial Suppurations, Mali Hospital
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.3,
September
28,
2021
ABSTRACT: Introduction: Intracranial suppurations are neoformed purulent
collections including, in decreasing order, cerebral abscesses, subdural empyemas
and extradural empyemas. Otorhinolaryngologic infections are one of the main
causes, especially in older children and adolescents. We report 3 clinical
cases of endocranial suppurations treated at the Mali Hospital. Clinical
Cases: 1) Observation 1. IK was a 14-year-old boy, who was hospitalized in
our department for fever, headache and left hemiplegia. The emergency brain
scan showed a right frontal and interhemispheric subdural empyema associated
with multifocal sinusitis. Surgical drainage associated with ceftriaxone: 100
mg/Kg/d in direct intravenous (DI), metronidazole: 10 mg/Kgs/12hours in slow
intravenous (SI) for 15 days, gentamycin: 3 mg/Kgs/d in SI for 3 days,
paracetamol 15 mg/Kgs/6hours in SI, 10% glucose serum: 100 ml/Kg/d were given.
The bacteriological analysis of the pus came back sterile. The postoperative
period was calm. 2) Observation 2. This was a 14-year-old boy with a history of
headaches who was admitted to our department for left hemiplegia. An emergency
brain scan showed a right pre-suppurative encephalitis associated with a right
fronto-ethmoidal and maxillary sinusitis. He was put on ceftriaxone 100 mg/kg/d
in DI for 21 days, gentamycin: 3 mg/Kg/d in SI for 3 days; metronidazole: 10
mg/kg/12hours in SI for 21 days, paracetamol: 15 mg/kg/6hours in SI. After 3
weeks of medical treatment, a follow-up brain scan revealed an interhemispheric
and right subdural empyema. Surgical drainage was associated with the triple
antibiotic therapy initially instituted. The bacteriological analysis of the
pus was sterile. The postoperative course was calm. 3) Observation 3. N.M was
an 11-year-old boy, who was admitted with fever and left hemiplegia. An
emergency brain scan revealed a right hemispheric subdural empyema associated
with an intracerebral abscess and pansinusitis. Surgical drainage associated
with ceftriaxone 100 mg/kg/d in DI for 15 days, gentamycin; 3 mg/kg/d in SI for
3 days, metronidazole: 10 mg/kg/12hours in SI for 15 days and paracetamol: 15
mg/kg/6hours in SI were instituted. Staphylococcus aureus was isolated
in the pus of the abscess. The postoperative course was calm. Conclusion: Endocranial suppurations of sinus origin are serious and frequent infections in
children in developing countries. Its diagnosis must be evoked in front of any
hemiplegia associated with a fever or headache and confirmed by a cerebral
scanner.