Cerebral abscess and empyema complicating pansinusitis in an 11-year-old child: report of a case to the pediatrics of the Mali Hospital

Abstract

Introduction: Brain abscess is an intracranial suppuration producing a newly formed cavity. Otorhinolaryngological infections are one of the main causes. We report a case of cerebral abscess and empyema complicating pansinusitis in an 11-year-old adolescent treated at the Mali Hospital.

Observation: He was an 11-year-old adolescent with a history of chronic headache who was admitted for left hemiplegia. The onset dates back to around 15 days marked by an unquantified fever, headache and then coma. A brain scan performed during hospitalization revealed a brain abscess and empyema, hence its reference to the Mali Hospital. At the entrance he had a fever of 38.5 ° C and a poor general condition. He was aware, well oriented and consistent. He had flaccid left hemiplegia with preservation of peripheral sensitivity. Cardiorespiratory examination and oto-rhinolaryngological were normal.

Surgical drainage associated with medical treatment including ceftriaxone 100 mg/kg/d direct intravenous for 15 days, gentamycin; 3 mg/kg/d intramuscular for 3 days, metronidazole : 10 mg/kg /12 hours intravenously slowly for 15 days, paracetamol: 15 mg/kg /6 hours intravenously slowly, glucose serum 10%: 100 ml/kg /day infused and red blood cell concentrate group O+: 20 ml/Kg intravenously slowly have been introduced. The relay was done with ciprofloxacin 10mg/Kg/12 hours for 6 weeks by oral route. The postoperative follow-up was simple. He was discharged on the 15th day of hospitalization.

Conclusion: Intracranial complications of sinusitis are serious and common in children in developing countries. The brain scanner is an indispensable tool for its diagnosis. Management is multidisciplinary. Prophylaxis is based on the correct treatment of otorhinolaryngological and oral infections.