Images in Intensive Medicine
Subdural empyema as a complication of odontogenic maxillary sinusitis
Empiema subdural secundario a sinusitis maxilar de origen odontógeno
N. Palomo López, M.D. Freire Aragón
, V. Rivera Fernández
Corresponding author
Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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(A) Area of consolidation showing hepatized lungs with aerial bronchogram showing hyperechogenic lines parallel to the pleura in the consolidated area (arrow) and fluid bronchogram with hyperechoic zones in the consolidated area (asterisk), lack of A lines and pleural reinforcement with pleural effusion consistent with a pattern of atelectasis. HFOV respiratory parameters: MAP 12, amplitude 40 and frequency 9. (B) Abundant coalescent B lines (asterisk) indicative of opening of atelectasis in the presence of pulmonary edema. Reinforcement of pleural echogenicity and pleural effusion. Increased respiratory parameters to MAP: 15, amplitude 50 and frequency 8. (C) Lung recruitment with normal parenchyma; presence of A lines (arrow) and scarce B lines (asterisk). Increased respiratory parameters to MAP: 18, amplitude 55 and frequency 8.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "B. del Rey Hurtado de Mendoza, J. Sanchez-de-Toledo, J. 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"apellidos" => "Rodríguez-Fanjul" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569117302139" "doi" => "10.1016/j.medin.2017.07.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569117302139?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301462?idApp=WMIE" "url" => "/21735727/0000004200000008/v1_201810270616/S2173572718301462/v1_201810270616/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>" "titulo" => "Subdural empyema as a complication of odontogenic maxillary sinusitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e21" "paginaFinal" => "e22" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "N. Palomo López, M.D. Freire Aragón, V. Rivera Fernández" "autores" => array:3 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Palomo López" ] 1 => array:4 [ "nombre" => "M.D." "apellidos" => "Freire Aragón" "email" => array:1 [ 0 => "lola_freire@ono.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Rivera Fernández" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Cuidados Intensivos, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Empiema subdural secundario a sinusitis maxilar de origen odontógeno" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1230 "Ancho" => 2333 "Tamanyo" => 120412 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Craniofacial CT scan (coronal slice 2A and axial slice 2B). Invasion of right maxillary sinus including cystic lesion suggestive of periapical cyst (arrow). Ipsilateral frontal pneumocephalus.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Twenty-one-year-old male patient with right-sided hemicrania continua headache, fever and purulent rhinorrhea presented with a diagnosis of right maxillary sinusitis that remains unresponsive to antibiotic therapy. The patient was re-evaluated more than 10 days after showing these symptoms, and one craniofacial TC scan with contrast was conducted that confirmed right pansinusal involvement and one extense extra-axial subdural frontoparietal ipsilateral collection that was consistent with empyema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Urgent neurosurgery was performed with evacuation of the subdural suppurated collection. After reviewing the CT scan, one round unilocular lesion was seen with well-established edges inside the right maxillary sinus and associated with piece 16 and consistent with a complex periapical cyst (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B). After identifying the primary focus of infection, one exodontia procedure was performed resulting in abundant pus and curettage of the sinus with favorable clinical progression.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-07-11" "fechaAceptado" => "2017-07-13" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Palomo López N, Freire Aragón MD, Rivera Fernández V. Empiema subdural secundario a sinusitis maxilar de origen odontógeno. Med Intens. 2018;42:e21–e22.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1334 "Ancho" => 1250 "Tamanyo" => 104081 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cranial CT scan with contrast (axial slice). Right subdural hypodense extra-axial collection with peripheral enhancement and mass effect.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1230 "Ancho" => 2333 "Tamanyo" => 120412 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Craniofacial CT scan (coronal slice 2A and axial slice 2B). Invasion of right maxillary sinus including cystic lesion suggestive of periapical cyst (arrow). Ipsilateral frontal pneumocephalus.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004200000008/v1_201810270616/S2173572718301395/v1_201810270616/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004200000008/v1_201810270616/S2173572718301395/v1_201810270616/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301395?idApp=WMIE" ]
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