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Alexandru Coman

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

APORTUL IMAGISTICII IN DIAGNOSTICUL COMPLICATIILOR INTRACRANIENE SECUNDARE OTOMASTOIDITEI LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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APORTUL IMAGISTICII IN DIAGNOSTICUL COMPLICATIILOR INTRACRANIENE SECUNDARE OTOMASTOIDITEI LA COPIL

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REZUMAT

Introducere. Otita medie (OM) acută este, una dintre cele mai comune infecţii diagnosticate în patologia copilului, cu evoluţie autolimitată cel mai frecvent (1,2). Ea poate duce în 2-6% dintre cazuri (2) spre complicaţii supurative intracraniene cu evoluţie nefavorabilă, fatală în 8-26,3% din ele (2,3). Apariţia semnelor neurologice în evoluţia unei otite supuraţive necesită investigaţii imagistice de urgenţă (2-8).

Material şi metodă. Se prezintă cazul unei fetiţe de 10 ani diagnosticată cu otită supurată complicată, transferată la Spitalul Clinic de Urgenţa pentru Copii „M.S. Curie“ Bucureşti în secţia ORL după o evoluţie a bolii de 2 săptămâni. Copilul se prezintă la internare cu: febră, otoree purulentă, semne neurologice reprezentate de cefalee, convulsii, redoare de ceafă. Se efectuează în urgenţă un examen computer tomografic (CT) cu substanţă de contrast intravenoasă (iv).

Rezultat. Examenul CT, extins şi la nivel cervical evidenţiază prezenţa unui proces litic la nivelul stancii temporale şi soluţie de continuitate între antrul mastoidian şi meninge, şi evidenţierea unui abces epidural perisigmoidian, tromboza de sinus sigmoid extinsă la nivelul jugularei şi sinusului lateral, semne de meningită, cerebrită cerebeloasă, abces cerebral şi empiem subdural.

Concluzii. Complicaţiile în infecţiile urechii medii sunt rare, însă apariţia semnelor neurologice la examenul fizic impune un examen imagistic care poate preciza arhitectura locală, prezenţa complicaţiilor locale sau la distanţa pentru instituirea unui tratament adecvat şi rapid.

Cuvinte cheie: copil, otită medie, complicaţii, computer tomograf (CT)

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CONTRIBUTION OF IMAGING EXAMINATIONS IN DIAGNOSIS OF INTRACRANIAL COMPLICATIONS IN CHILDREN OTOMASTOIDITIS

SELECT ISSUE

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
Scopus
NLM Catalog
Ebsco Host - Medline
Semantic Scholar

HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

CONTRIBUTION OF IMAGING EXAMINATIONS IN DIAGNOSIS OF INTRACRANIAL COMPLICATIONS IN CHILDREN OTOMASTOIDITIS

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ABSTRACT

Introduction. Otitis media (OM) is one of the most common infections in child pathology, most often with selflimited evolution (1,2). In 2-6% of cases (2) developed, intracranial complications with unfavorable, fatal outcome in 8-26.3% of them (2,3). Presence of neurological signs in the evolution of suppurative otitis require early imaging examinations (2-8).

Material and methods. We presents the case of a 10 year old girl with suppurative otitis complicated, transferred to the Clinical Emergency Hospital for Children „M.S. Curie“, Bucharest to ENT department after 2 weeks of disease progression. The child presents at hospital: fever, purulent otorrhea, neurological signs represented by headache, seizures, stiff neck. Contrast-enhanced computed tomographic (CT) were performed in emergency.

Result. CT scanning, extended to the neck show the presence of a lytic process in the temporal bone, solution of continuity between mastoid antrum and meninges with epidural abscess form over sigmoid sinus, trombophlebitis and thrombus of sigmoid sinus, which is propagate to the lateral sinus and the jugular vein; signs of meningitis, cerebellar cerebritis, brain temporal abscess and subdural empyema.

Conclusions. Complications in middle ear infections are rare, but the appearance of neurological signs in clinical examination must be completed by CT of head with contrast, which can specify local architecture, presence of local or distant complications, help in the application to a fast and appropriate therapy.

Keywords: child, otitis media, complications, computer tomography (CT)

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