Isolated acute sphenoid sinusitis as an unexpected cause of acute headache in a 9-year-old male

Abstract

Isolated sphenoid sinusitis represents a rare pathology encountered in the pediatric population. The clinical presentation is often nonspecific and misleading, thus causing a delay in diagnosis. Progressive acute headache is the chief complaint, followed by cranial nerve involvement, most frequently the optic nerve. The underlying pathology and evolution towards ocular or intracranial complications reside in the particularities of the sphenoid sinus and in its close relations with the surrounding anatomical structures. Prompt diagnosis and initiation of wide-spectrum antibiotherapy are vital for an optimal therapeutic outcome with preservation of normal vision. We report a case of a previously healthy 9-year-old male who presented for an intense progressive headache without any neurological signs. Under intravenous antibiotherapy he had a rapid favourable evolution and did not develop any complications. An emphasis is put on the importance of a rapid diagnosis followed by prompt treatment with close monitoring.

Keywords

• secondary headache
• sphenoid sinus
• bacterial sinusitis