Parietal subdural empyema as complication of acute odontogenic sinusitis: a case report.

Abstract

INTRODUCTION:

To date intracranial complication caused by tooth extractions are extremely rare. In particular parietal subdural empyema of odontogenic origin has not been described. A literature review is presented here to emphasize the extreme rarity of this clinical entity.

CASE PRESENTATION:

An 18-year-old Caucasian man with a history of dental extraction developed dysarthria, lethargy, purulent rhinorrhea, and fever. A computed tomography scan demonstrated extensive sinusitis involving maxillary sinus, anterior ethmoid and frontal sinus on the left side and a subdural fluid collection in the temporal-parietal site on the same side. He underwent vancomycin, metronidazole and meropenem therapy, and subsequently left maxillary antrostomy, and frontal and maxillary sinuses toilette by an open approach. The last clinical control done after 3 months showed a regression of all symptoms.

CONCLUSIONS:

The occurrence of subdural empyema is an uncommon but possible sequela of a complicated tooth extraction. A multidisciplinary approach involving otolaryngologist, neurosurgeons, clinical microbiologist, and neuroradiologist is essential. Antibiotic therapy with surgical approach is the gold standard treatment.

• Authors: Francesco Martines, Pietro Salvago, Sergio Ferrara, Marianna Mucia, Angelo Gambino, Federico Sireci
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 8 Pg. 282 (Aug 21 2014) ISSN: 1752-1947 [Electronic] England
• PMID: 25146384 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Thienamycins
• Metronidazole
• Vancomycin
• Meropenem

Topics

• Acute Disease
• Adolescent
• Anti-Bacterial Agents (therapeutic use)
• Craniotomy (methods)
• Diagnosis, Differential
• Empyema, Subdural (drug therapy, etiology, surgery)
• Follow-Up Studies
• Humans
• Male
• Maxillary Sinus (diagnostic imaging, surgery)
• Meropenem
• Metronidazole (therapeutic use)
• Parietal Lobe (diagnostic imaging)
• Sinusitis (complications, diagnostic imaging, drug therapy)
• Subdural Space (diagnostic imaging)
• Thienamycins (therapeutic use)
• Tomography, X-Ray Computed (methods)
• Tooth Extraction (adverse effects)
• Treatment Outcome
• Vancomycin (therapeutic use)