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Temporal lobe abscess in a patient with isolated sphenoiditis
Thomas A Stewart1, Cody S Carter, Kristin Seiberling
1Department of Otolaryngology, Loma Linda University, Loma Linda, California.
Allergy & Rhinology (Providence, R.I.)
|August 2, 2012
Summary
A severe headache led to the diagnosis of isolated sphenoiditis in an immunocompetent man. Fungal debris in the sinuses and a temporal lobe abscess were found, requiring surgery for full recovery.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Isolated sphenoiditis can present with severe retro-orbital headaches.
- Immunocompetent individuals can develop serious intracranial complications from sinus infections.
Observation:
- A 74-year-old man with isolated sphenoiditis became obtunded, revealing a temporal lobe abscess on CT scan.
- Surgical intervention included left temporal craniectomy and bilateral endoscopic sphenoid sinusotomy.
Findings:
- Gross fungal debris was discovered during the sphenoidotomy.
- The patient achieved a full recovery with resolution of both the abscess and sinus pathology.
Implications:
- Neurological changes in sinus patients warrant suspicion for intracranial infection.
- Prompt diagnosis via imaging and surgical drainage are crucial to prevent permanent neurological deficits.
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