Les Ethmoidites Aigues Exteriorisees De L\'enfant Etude De 11 Observations

Abstract

INTRODUCTION L'ethmoïdite aiguë (EA) est l'infection bactérienne des cellules du labyrinthe ethmoïdal. Il s'agit d'une infection sévère, nécessitant un diagnostic et un traitement urgents du fait du risque de complications ophtalmologiques et endocrâniennes [1].Elle survient le plus souvent entre l'âge de 6mois et 5 ans. Le signe d'appel est l'apparition dans un contexte fébrile d'un oedème palpébral [2]. Le traitement repose essentiellement sur l'antibiothérapie à large spectre. La chirurgie est réservée aux formes compliquées. Le but de notre étude est d'analyser les caractéristiques clinico-radiologiques et thérapeutiques de cette affection à travers 11 observations et une revue de la littérature.

Acute ethmoiditis complicated by intraorbital abscess, orbital cellulitis, and cerebral empyema in a 14‐year‐old girl

“…Several recent studies show that emergency ethmoid‐orbital and cerebral CT remain the examinations of choice for making the diagnosis and specifying the locoregional extension of the complications, allowing emergency treatment to be instituted. Our patient's clinical picture (high fever of 39.9°C, painful swelling, and protrusion of the left eye for several days the following nasopharyngitis) indicated this from the first day of hospitalization 7–12 . Inflammation with hyperleukocytosis remains an observation in several studies 6,13 .…”

“…Orbital and subperiosteal abscesses, as well as orbital cellulitis, are the complications of ethmoidomaxillary sinusitis found by several authors, 2,6,17 but in this study, the medial frontal cerebral empyema and focal signs were found beyond the orbital cellulitis and the Chandler IV retro‐orbital abscess, and this would be explained by the indirect propagation of the infection by the hematogenous route through the ophthalmic veins without valves. In our study, blood culture before starting antibiotic therapy and the search for soluble antigens would have increased the probability of identifying the germ in our study 7,18 …”

“…In our study, blood culture before starting antibiotic therapy and the search for soluble antigens would have increased the probability of identifying the germ in our study. 7 , 18 …”

“…Our patient's clinical picture (high fever of 39.9°C, painful swelling, and protrusion of the left eye for several days the following nasopharyngitis) indicated this from the first day of hospitalization. [7][8][9][10][11][12] Inflammation with hyperleukocytosis remains an observation in several studies. 6,13 According to Chandler, most of the authors recommend empirical broad-spectrum antibiotic therapy by the intravenous route, combining third generation cephalosporins or amoxicillin/clavulanic acid with quinolones, aminoglycosides, and imidazoles, depending on the stage of the disease.…”

Acute ethmoiditis complicated by intraorbital abscess, orbital cellulitis and cerebral empyema in a 14-year-old girl. About a case.

“…Orbital and sub-periosteal abscesses, as well as orbital cellulitis, are the complications of ethmoidomaxillary sinusitis found by several authors [2,5,16], but in the present study, the medial frontal cerebral empyema and focal signs were found beyond the orbital cellulitis and the Chandler IV retro-orbital abscess, and this would be explained by the indirect propagation of the infection by the hematogenous route through the ophthalmic veins without valves. In our study, blood culture before starting antibiotic therapy and the search for soluble antigens would have increased the probability of identifying the germ in our study [6,17].…”