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Delayed Diagnosis of Subdural Empyema in a Septic Child

Adam Janicki1, Geoffry Capraro1

  • 1Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.

Rhode Island Medical Journal (2013)
|August 1, 2015
PubMed

Insights

Prompt sepsis identification in children is crucial. Delayed diagnosis of intracranial complications from bacterial sinusitis can lead to severe outcomes, emphasizing the need for vigilant emergency physician assessment.

Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Diseases
  • Neurology

Background:

  • Sepsis in children requires prompt identification and treatment for optimal outcomes.
  • Acute bacterial sinusitis is common in children and can rarely lead to intracranial complications.
  • Intracranial complications of sinusitis carry significant morbidity and mortality risks.

Observation:

  • A case of pediatric sepsis is presented where intracranial extension of bacterial sinusitis was initially missed.
  • The patient experienced subsequent complications due to the delayed diagnosis.

Findings:

  • Physical examination and initial history may not reliably detect acute bacterial sinusitis or its intracranial spread.
  • Subdural empyema is a rare but serious complication that should be considered in pediatric sepsis cases.

Implications:

  • Emergency physicians must maintain a high index of suspicion for subdural empyema in children with sepsis.
  • Early recognition and management of the infectious source, including intracranial complications, are vital for pediatric sepsis recovery.

Keywords:
Infectious DiseasePediatricsSepsisSinusitisSubdural Empyema

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