Chronic rhinosinusitis complicated by intracranial suppuration

Abstract

Background Intracranial abscess formation secondary to chronic rhinosinusitis (CRS) is a rare, but life-threatening infection with a poor outcome. Case presentation A 63-year old Caucasian male with a history of CRS presented with one day of fever (40,3 °C), repeated vomiting, two episodes of generalized seizures, and later became unresponsive. The patient was diagnosed with pansinusitis and a cerebral abscess, and he was treated successfully with surgery and antibiotic therapy. At follow-up nearly 9 years later, the patient had only minor complaints despite severe sinus pathology on the follow-up computed tomography scan. Conclusion Early diagnosis and treatment of intracranial complications are essential to reduce subsequent morbidity and mortality. After an acute exacerbation, imaging findings and subjective complaints may differ. Treatment should, therefore, be based on a combination of objective and subjective findings.

Keywords

• adult rhinology
• chronic rhinosinusitis
• intracranial suppuration
• cerebral abscess
• streptococcus