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Intracranial abscess from facial cellulitis.
Jonghyun Park1, Woo Seob Kim1, Han Koo Kim1
1Department of Plastic and Reconstructive Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Facial cellulitis can indicate serious underlying issues, even years after surgery. Prompt diagnosis and treatment, including imaging and surgery, are crucial for resolving deep-seated infections like epidural abscesses.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Cellulitis is a common skin infection, usually minor, but can rarely lead to severe complications.
- A patient presented with recurrent facial cellulitis following acupuncture, with a remote history of craniectomy.
Observation:
- Initial facial cellulitis resolved with antibiotics but recurred.
- Patient reported a blunt headache, with no overt neurological signs.
- Brain CT revealed subgaleal and epidural abscesses, linked to the 20-year-old craniectomy.
Findings:
- Surgical intervention (craniotomy) and abscess evacuation were performed.
- Postoperative antibiotic treatment was administered.
- Follow-up imaging confirmed complete resolution of the abscesses.
Implications:
- This case highlights the importance of considering deep-seated infections in recurrent cellulitis, especially with a history of neurosurgery.
- Delayed diagnosis of intracranial abscesses can lead to severe morbidity.
- Thorough patient history, including remote surgical interventions, is critical for accurate diagnosis and management.
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