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Sinusitis Complicated by Meningitis: Current Management
Author(s) -
Younis Ramzi T.,
Anand Vinod K.,
Childress Curt
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200108000-00006
Subject(s) - medicine , sinusitis , meningitis , sequela , complication , surgery , sinus (botany) , brain abscess , streptococcus pneumoniae , pediatrics , abscess , antibiotics , botany , microbiology and biotechnology , biology , genus
Objectives Meningitis is the most common intracranial complication of sinusitis. We review the incidence, current management, outcomes, and complications of this serious infection. Our study also examines the evolving roles of endoscopic sinus surgery and other new therapeutic and diagnostic modalities in our armamentarium. Study Design A retrospective chart review was performed at a tertiary academic medical center of all patients diagnosed with sinusitis with complications between January 1985 and December 1999. Methods The patients were divided into two main groups: intracranial versus orbital complications. Meningitis was the most common intracranial complication. Data on patients with sinusitis and meningitis were collected and analyzed. Results Intracranial complications were present in 39 of 82 patients whereas orbital complications were noted in 43 patients. Twenty‐one of the 39 intracranial complications were meningitis. The most common computed tomography finding in adults (54%) was sphenoid sinusitis. All patients with AIDS (6 of 21) had unique cryptococcus meningitis. In patients without AIDS, the most common organism was Streptococcus pneumoniae (10 of 21). The most common sequela was seizure disorder (4 of 21). Endoscopic sinus surgery was performed on 7 of 21 patients. One patient with AIDS who had sinusitis and meningitis died. Conclusions Meningitis as a complication of sinusitis may still pose a serious threat. Although outcomes are encouraging, sequelae such as seizure disorders and hearing loss are common complications. The introduction of high‐resolution computed tomography scans and magnetic resonance imaging and the availability of wide‐spectrum antibiotics have improved our management significantly.