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PubMed2005

Concomitant bilateral orbital and brain abscesses--unusual complications of pediatric rhinosinusitis.

Rhinosinusitis is a common medical problem. Complications involving the orbits or brain are not frequently met. Concomitant involvement of both orbits and the brain is very rare. We here describe a 6-year-old girl who suffered from acute rhinosinusitis and initially, subperiosteal abscesses in both orbits. Bilateral functional endoscopic sinus surgery and drainage of the subperiosteal abscesses through the upper eyelids were done. Pus cultures showed methicillin-resistant Staphylococcus aureus. The brain abscesses were found under magnetic resonance imaging (MRI) and were treated conservatively with vancomycin and rifampin for 7 weeks. The patient was free of ouular and necurologic sequelae at the 1-year follow up. Retrograde thrombophlebitis instead of anatomic dehiscence was the most likely route for the spread of infection. Multidisciplinary approaches are necessary in managing ophthalmologic and intracranial complications of sinusitis.

Abscess↗
PubMed1949

Brain abscess.

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Brain↗
PubMed1987

[Effect of hydrocortisone on changes in the hypothalamo-hypophyseal system in experimental brain abscess].

The experiment involved 296 rats. In untreated rats (n = 123) with an experimental abscess of the temporal lobe changes in the hypothalamus-pituitary neurosecretory system (HPNS) in the first 10 days of the process development were characterized by inhibited activity of HPNS and were paralleled by the presence of an extensive purulent focus in the brain, a grave status of the animals and frequent lethal outcomes. The long-term period (on the 15th-30th day) was characterized by a reduced intensity of the inflammatory process and a decreased mortality rate. The effect of hydrocortisone (HC) on changes in the HPNS and tissue of the abscess-affected brain was investigated in 156 rats. In the first 7 days of the experiment HC decreased the inflammatory reaction and metabolic disorders in the cerebral tissue, activated HPNS and reduced the mortality rate. The use of HC for more than 10 days enhanced metabolic disturbances and brain oedema, inhibited HPNS activity and increased the mortality rate. On the basis of the results obtained the author justifies the necessity of HC employment for the stimulation of adaptive reactions of the body in the form of a short course of treatment in the acute period of the development of brain abscess.

Adaptation, Physiological↗