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Suppurative intracranial complications of sinusitis in previously healthy children

Megan H Bair-Merritt1, Samir S Shah, Theoklis E Zaoutis

  • 1Pediatric Generalist Research Group, Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

The Pediatric Infectious Disease Journal
|April 9, 2005
PubMed

Insights

Suppurative intracranial complications of sinusitis in children are uncommon but serious. Streptococcus milleri group and anaerobic bacteria are frequent causes in previously healthy pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Sinusitis is a common pediatric illness.
  • Intracranial complications of sinusitis, though rare, can lead to significant morbidity and mortality.
  • Understanding the clinical presentation and causative pathogens is crucial for timely diagnosis and management.

Purpose of the Study:

  • To describe the clinical features and microbiology of suppurative intracranial complications secondary to sinusitis in children.
  • To identify common pathogens involved in these serious infections.

Main Methods:

  • Retrospective case series.
  • Review of clinical data and microbiological findings for 16 pediatric patients.
  • Analysis of presenting symptoms, neurological signs, and identified microorganisms.

Main Results:

  • 16 previously healthy children were identified with suppurative intracranial complications of sinusitis.
  • The majority of cases involved male adolescents presenting with vomiting and sinusitis symptoms.
  • Neurological signs were frequently absent at presentation.
  • Commonly identified pathogens included Streptococcus milleri group organisms and anaerobes.

Conclusions:

  • Suppurative intracranial complications of sinusitis can occur in previously healthy children.
  • Vomiting is a key presenting symptom in adolescents, often alongside typical sinusitis signs.
  • Absence of focal neurological deficits does not exclude intracranial involvement.
  • Prompt microbiological investigation and targeted antibiotic therapy are essential for favorable outcomes.

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