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The pediatric headache that would not go away.

Abstract
We describe the clinical presentation, radiographic findings, management, and outcome of a subdural empyema in a 14-year-old male with history of recent partially treated acute sinusitis. Subdural empyema is a rare but life threatening complication, usually following paranasal sinusitis, otitis media, mastoiditis, cranial surgery, a skull fracture, or from distant spread from sites such as a pulmonary infection. The initial evaluation should include a thorough history and physical examination, complete blood count, electrolytes, C-reactive protein, erythrocyte sedimentation rate, chest x-ray, urinalysis, and neuroimaging of the brain with intravenous contrast. If a subdural empyema is identified, then intravenous antibiotics should be initiated, and immediate neurosurgical consultation should be obtained to consider operative drainage.
AuthorsBryan Dunn, Chad McCalla, Brian Hiestand, Mary Claire O'Brien
JournalPediatric emergency care (Pediatr Emerg Care) Vol. 29 Issue 12 Pg. 1283-6 (Dec 2013) ISSN: 1535-1815 [Electronic] United States
PMID24300473 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Bacterial Agents
Topics
  • Adolescent
  • Anti-Bacterial Agents (therapeutic use)
  • Bacteremia (diagnosis, drug therapy)
  • Consciousness Disorders (etiology)
  • Diagnostic Errors
  • Emergency Service, Hospital
  • Empyema, Subdural (complications, diagnosis, microbiology, therapy)
  • Fever (etiology)
  • Frontal Sinusitis (complications, diagnostic imaging, microbiology)
  • Gram-Positive Bacterial Infections (diagnosis, etiology, therapy)
  • Headache (etiology)
  • Hematoma, Subdural (diagnosis)
  • Humans
  • Male
  • Migraine Disorders (diagnosis)
  • Peptostreptococcus (isolation & purification)
  • Tomography, X-Ray Computed

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