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This article presents a clinical case of successful surgical treatment of a 16-year-old patient with subdural empyema of the interhemispheric fissure and the left hemisphere of the brain, which developed against the background of pansinusitis. The patient was admitted to the emergency department with symptoms including headache, fever, and altered consciousness. A brain CT scan revealed subdural empyema and purulent pansinusitis, necessitating urgent surgical intervention. A decompressive craniectomy with drainage of the subdural empyema and transnasal endoscopic sinus drainage was performed. Bacteriological culture from the empyema identified Staphylococcus haemolyticus MRS, guiding the choice of antibiotic therapy. The successful surgical treatment and timely adjustment of antibiotic therapy significantly improved the patient’s condition and prevented the development of complications. [ABSTRACT FROM AUTHOR]

Background: Functional endoscopic sinus surgery (FESS) is a powerful method to achieve good clearance of sinus disease and is being practiced for the better part of the last three decades. The Sinonasal Outcome Test (SNOT)-22 Questionnaire was developed as a modification of the SNOT – 20 in 2009 and helps in better understanding of the disease process before and after surgery as it includes the functioning of special senses. Objective: The objective of this study was to assess the role and reliability of SNOT-22 in pansinusitis undergoing full-house FESS. Materials and Methods: The study was conducted in a tertiary hospital in rural South India from July 2021 to December 2021. Two hundred and thirteen patients were evaluated, and out of these, only 69 patients met the inclusion criteria. Surgery was performed under general anesthesia using cold steel instruments. SNOT-22 was administered 1 day before surgery and after 12 weeks postsurgery. Observations and Results: The average preoperative score in the SNOT-22 scale was 46.16 out of a maximum of 110 and the average postoperative score was 18.70 (an improvement of 59.50%, P < 0.05). Forty-two males and 27 females made it to the final study. The most common age of the patient at the time of presentation was between 21 and 30. Conclusion: Performing a full-house FESS for pansinusitis in cases with improper follow-up can be done without any side effects provided they are monitored with the SNOT-22 Questionnaire. This study can help practitioners achieve good success rates with lower revision surgery requirements.

Orbital cellulitis is an infrequent but serious infectious complication of rhinosinusitis, most commonly seen in the pediatric population. Extension into the cavernous sinus, leading to further infection and thrombosis, is a rare but life-threatening complication. Although COVID-19 has been linked to an increased risk of venous thromboembolism, most cases involve extremity deep venous thrombosis or pulmonary embolism; reports of intracranial or jugular system thrombosis are rare. We describe a case of a 17-year-old female patient with no significant medical history or thrombotic risk factors found to have orbital cellulitis and severe pansinusitis, complicated by multiple venous thromboses in the head and neck requiring emergent surgical intervention and pediatric intensive care admission. Extensive head and neck venous thrombosis and intracranial abscesses are rare complications of pansinusitis and orbital cellulitis, and the thrombotic complications of COVID-19 are well documented. A delay in diagnosis and treatment can lead to potentially devastating consequences. [ABSTRACT FROM AUTHOR]

Granulomatosis with polyangiitis is a rare vasculitis characterized by necrotizing granulomatous inflammation affecting small blood vessels. It often presents with pulmonary masses and nodules, mimicking malignancy in imaging studies. Distinguishing granulomatosis with polyangiitis from cancer is crucial due to differing treatment approaches and prognoses. We describe a 54-year-old male with granulomatosis with polyangiitis presenting with headache, bilateral ear discharge, cough, and weight loss. Imaging revealed metabolically active lesions in the lungs and nasopharynx, initially suggestive of metastatic malignancy. Biopsies from the lung and nasopharyngeal lesions showed necrotizing granulomatous vasculitis, which was suggestive of granulomatosis with polyangiitis. Serological testing was positive for cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA) with elevated proteinase 3 (PR3) antibodies. This case underscores the diagnostic challenges of granulomatosis with polyangiitis, which can mimic malignancy radiologically. Early recognition and treatment initiation are pivotal in improving patient outcomes and preventing organ damage in granulomatosis with polyangiitis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mohan et al.)

La pansinusitis se define como la inflamación de todos los senos paranasales, de uno o los dos lados de la nariz, a consecuencia de la invasión por bacterias, virus u hongos, el cual puede ser causada por la evolución de una lesión en el diente con formación de pus periapical que avanza en el interior de la cavidad sinusal. (1) La evaluación temprana de los pacientes que manifiesten invasiones dentales es esencial con el fin de evitar las complicaciones clínicas que puedan detonar en la penetración de dicha cavidad. Del mismo modo se debe estar atento a realizar un diagnóstico temprano y la respectiva cobertura antibiótica en conjunto con las pruebas de sensibilidad antibiótica en pacientes con empeoramiento del cuadro clínico de origen odontogénico.

INTRODUCTION: Pott's puffy tumour is an uncommon complication of frontal sinusitis not previously diagnosed or with poor treatment, which can cause intracranial involvement, causing permanent neurological sequelae. CASE REPORT: An 11-year-old male, evaluated for a recent onset tumor and headache in which computed tomography and cranial nuclear magnetic resonance imaging are requested on suspicion of complicated acute sinusitis, detecting a Pott's puffy tumour secondary to uncomplicated pansinusitis, so that broad-spectrum intravenous antibiotic therapy is prescribed, surgery not being necessary due to the stable clinical characteristics of the lesion as well as the rapid establishment of the treatment, presenting the patient with adequate clinical evolution, without subsequent neurological sequelae. CONCLUSION: The clinical suspicion of the pediatrician is essential to avoid serious intracranial complications. Although surgical treatment is most often necessary, a more conservative attitude with broad-spectrum antibiotic therapy may be sufficient in clinically stable patients with a normal level of consciousness and without neurological deficits. [ABSTRACT FROM AUTHOR]

Introduction: We report a rare case of pan sinusitis with orbital cellulitis in a 3-year-old male child. Orbital cellulitis is considered as an ocular emergency which needs urgent evaluation and proper quick action to save the patient vision or even life. It can affect both adults and children but has a greater tendency to occur in the pediatric age group. Methods: A 3-year-old male child presented to us with history of fever since 15 days. Later he developed swelling of left eye lid since 8 days. His visual acquity was fixating and following light. On anterior segment examination there was diffuse upperlid edema of left eye associated with mild erythema and matting of lashes. On MRI, it shows left sided pansinusitis with orbital cellulitis. Results: In view of left sided pansinusitis with orbital cellulitis, Functional Endoscopic Sinus Surgery with orbital decompression was done. Pus from the middle meatus was taken, sent for culture and sensitivity and the organism isolated was methicillin resistant Staphylococcus aureus (MRSA) positive growth and child was continued on antibiotics i.e., Teicoplanin and Metrogyl. Patient showed marked improvement in both ocular and general condition. Conclusion: Currently, imaging studies for detection of orbital abscess, the use of antibiotics and early drainage have mitigated visual morbidity significantly. The purpose of this review is to describe current investigative strategies and management options in the treatment of orbital cellulitis, establish their effectiveness and possible complications due to late intervention. This case report will be of interest particularly to the ophthalmologists, the otorhinolaryngologists, and the paediatricians.

Aim The study aims to analyze the imaging findings of invasive rhino-orbital-cerebral mucormycosis (ROCM) in patients who had COVID-19. Materials and methods This retrospective descriptive study was done on confirmed (culture and histopathology) patients who had a COVID-19 infection. The data was collected from the record section from May 2021 to June 2021. Imaging data were analyzed, and findings were tabulated according to statistical methods. Results Radiological evaluation, including CT and MRI, was done in 48 cases. The ethmoid sinus was the most common sinus involved in 60.41% of cases, followed by the maxillary sinus (52.09%). Unilateral pansinusitis was observed in 21 cases (43.75%). Among periantral extensions, retroantral fat involvement was the most common finding, seen in 24 cases (50%). Lamina papyracea and the walls of the maxillary sinus were involved in eight cases (16.67%). A total of 38 cases (79.17%) exhibited involvement of the extraconal compartment, while 32 cases (66.67%) showed involvement of the intraconal compartment. In intracranial involvement, infarct was noted in 13 cases (27%), and cavernous sinus involvement in nine cases (18.75%). Conclusions ROCM is a life-threatening fungal infection in immunocompromised patients, especially diabetics. Imaging of ROCM plays a pivotal role in early diagnosis, the extent of disease, surgical planning, prognosis, and the response to treatment. Radiologists must know the imaging features and patterns of extension of ROCM., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Indira Gandhi Institute of Medical Sciences issued approval 294/IEC/IGIMS/2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ranjan et al.)

Intracranial arachnoid cysts (AC) can lead to a bony thinning of the surrounding skull. We present a young man, in whom a frontal AC has caused a thinning of the frontal calvaria and of the posterior wall of the frontal sinus. This bony vulnerability allowed a frontal sinusitis to spread intracranially and finally led to a subdural empyema with neurological deterioration. The treatment consisted of an emergency craniotomy with evacuation of the empyema and appropriate antibiotic treatment of the causing pathogen (Streptococcus intermedius).

La trombosis séptica del seno cavernoso es una enfermedad rara que se presenta como una tromboflebitis en el seno cavernoso como complicación posterior a infecciones faciales, principalmente en la zona denominada zona de peligro ( tercio medio de la cara , alrededor de ojos y nariz ) zona que drena en la venas oftálmicas; además ,rinosinusitis (especialmente esfenoiditis y etmoiditis, celulitis, abscesos ,otitis media, , faringitis y con menos frecuencia infecciones dentales(1). Se puede presentar como un cuadro agudo que puede ser dramático y potencialmente mortal sin embargo en raras ocasiones se presenta como un cuadro subagudo o crónico. Su elevada morbimortalidad amerita que se realice un diagnóstico rápido y certero que evite secuelas graves. Se presenta el caso de un hombre que acude al servicio de emergencias con cuadro agudo de fiebre, eritema, dolor a nivel nasal y salida de secreción purulenta posterior a trauma punzante que posteriormente se diagnostica una trombosis séptica bilateral de senos cavernosos secundaria a una celulitis facial.

This study aimed to report the clinical profile of patients with rhino-orbital mucormycosis at a tertiary eye care center in Tamil Nadu. This was a single-center, retrospective case series of patients who were diagnosed as rhino-orbital mucormycosis between January and December 2018. The study included nine patients of rhino-orbital mucormycosis with a mean age of 53.33 ± 8.3 years (range: 35–61 years), comprising five males and four females. All the cases were unilateral in presentation. Uncontrolled diabetes mellitus was the most common underlying predisposing factor. Four patients presented with proptosis, two patients complained of headache, and five patients had defective vision. Computed tomography scan showed pansinusitis in six patients. Total ophthalmoplegia was noted in four patients. All patients received parenteral therapy with amphotericin B. Rhino-orbital mucormycosis is a rare, life-threatening, and insidious fungal infection. Uncontrolled diabetes mellitus and immunosuppression are the most important risk factors. The orbital findings may range from orbital pain to ophthalmoplegia and blindness. We present this case series to emphasize the importance of early diagnosis and treatment of rhino-orbital mucormycosis.

Isolated superior oblique (SO) palsy has been reported in cavernous sinus thrombosis, pituitary microadenoma, tuberculous meningitis, following intraoral local anesthesia, and inferior alveolar nerve block. A 14-year-old boy presented with right SO palsy. There was a history of facial cellulitis, following dental root canal treatment (RCT) 2 weeks back. Magnetic resonance imaging revealed right pansinusitis and breach of the lamina papyracea, with extension of inflammation into the orbit. Complete recovery was noted 1 week after functional endoscopic sinus surgery. The association of SO palsy with sinusitis can be explained by the anatomical proximity of the trochlear nerve to the paranasal sinus or by the extension of infection into the superior orbital fissure. Trochlear nerve is particularly vulnerable due to its location outside the annulus of Zinn. Although multiple ocular nerve palsy following sinusitis is well recognized, isolated SO palsy in pansinusitis following dental RCT has not been reported. An inflammatory etiology carries a favorable prognosis.

In children, epidural and/or subdural intracranial empyema can complicate frontal sinusitis or pansinusitis. The standard transcranial approach used to treat epidural or subdural empyema has many drawbacks, but these can be avoided with an endoscopic expanded endonasal approach (EEA). To support the feasibility and advantages of this approach, we report the successful drainage through endoscopic EEA of a bifrontal empyema caused by an intracranial extension of pansinusitis. Our case and the ones previously reported in the literature establish well that endoscopic EEA offers several advantages over the standard craniotomy. Hence, EEA should be considered as an alternative to the transcranial approach when surgically draining anterior skull base empyema resulting from pansinusitis in children. [ABSTRACT FROM AUTHOR]

The article presents an uncommon case of deafness. A patient with symptoms of acute rhinosinusitis with mastoiditis was hospitalized for antibiotics therapy and surgery. Objective examinations were characterized by muco-purulent nasal discharge, mucous middle ear secretion of both sides and starting protrusion of right eyeball. CT and MRI images were with complete obstruction of all nasal cavities and mastoids. The patient suffered from significant deterioration of hearing, up to deafness on the right side. After the FESS, there was no regression of the pathological condition. The results of histological examination of polypous tissue revealed the presence of advanced breast cancer with distant metastasis (stage IV). The first signs of this disease were acute pansinusitis with mastoiditis, eyeball protrusion and significant deterioration of hearing. [ABSTRACT FROM AUTHOR]

Frontal osteomyelitis is characterized by localized osteal inflammation of the frontal bone. This is a rare complication of acute frontal sinusitis. The present case is being reported to highlight the likely role of anatomical variations in frontal sinus drainage pathways in the causation of this complication apart from other known predisposing factors like young age and immunocompromised state. The patient initially presented with seizures, fever, and headache and was diagnosed with viral encephalitis. However, the symptoms gradually progressed to cause right eye swelling and an increase in the severity of headache without any nasal complaints. Diagnostic nasal endoscopy revealed mucopurulent secretions in both nasal cavities. Computed tomography and magnetic resonance imaging diagnosed the anatomical variations, the extent of sinus involvement, and frontal osteomyelitis. Antimicrobial therapy for an extended duration of four weeks, along with functional endoscopic sinus surgery resulted in excellent outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Wadhwa et al.)

A case of chronic sphenoidal sinusitis in a girl of 9 years old is proposed; in clinical picture oculomotor dysfunction occurred (ptosis, strabismus divergent, diplopia, epiphora). The condition was masked by neurological symptoms, and so initial differential diagnosis was between 1) ocular form of myopathy (including mitochondrial diseases), 2) ocular form of myasthenia and 3) onset of multiple sclerosis. The definite diagnosis «pansinusitis» was proposed by neurologist only after attentive analysis of clinical symptoms and data of MRI, only since 1,5 year after beginning of the disease. This clinical case demonstrates the complexity of differential diagnosis of chronic sphenoidal sinusitis in children and necessity of developed clinical thinking for a doctor of every speciality

IgG4-related diseases are a new nosological entity that encompasses a few previously known diseases. IgG4-related systemic disease is diagnosed if two or more affected organs are detected. This group of diseases has two similar signs: serological (elevated serum IgG4 subclass concentrations) and histological (organ and tissue infiltration from plasmo-cytes secreting IgG4, and eosinophils, and the development of fibrosclerosis and phlebitis obliterans). The paper describes two cases. In one case, a multisystemic disease was observed virtually at its onset whereas in the other this lesion was diagnosed several years after the natural course of the disease.

Se reporta el caso de un paciente masculino de 52 años, con antecedentes personales de diabetes mellitus tipo 2 en tratamiento con metformín quien consultó por cefalea intensa y congestión nasal. Se diagnosticó una pansinusitis que no respondió al manejo médico. Fue evaluado por medicina interna y otorrinolaringología y se encontraron costras secas, negras, en los cornetes y meatos mediante la fibronasolaringoscopia. Se practicó una resonancia magnética en la que se reportó una lesión en la región temporal izquierda asociada a edema vasogénico. Se programó para drenaje del absceso el cual se realizó sin complicaciones; en el estudio de histopatología se informó la presencia de hifas aseptadas que correspondían a Rhizopus sp. Se inició su manejo con anfotericina B para la mucormicosis rinocerebral con respuesta adecuada y se dio de alta por mejoría de su enfermedad.We report the case of a 52 years old male patient with type 2 diabetes mellitus under metformin therapy that presented with acute headache and nasal congestion. Pansinusitis was diagnosed which did not respond to medical treatment. He was evaluated by the internal medicine and otorrinolaringology departments. In the fibronasolaringoscopy exam black necrotic scars were found in turbinates and meatus. A magnetic resonance was ordered which evidenced a lesion in the left temporal region associated to vasogenic edema. The patient was programmed for abscess drainage without any complications; the histopathological report informed the presence of non septated hyphae compatible with Rhizopus sp. The patient began to receive amphotericyn B for a rhinocerebral mucormycosis with optimal response and was discharged with improvement of his clinical picture.

Objectives: To find out the effect of minimal invasive sinus surgery and balloon sinuplasty on mucociliary clearance and compare different methods of measuring mucociliary clearance. Methods: Twenty-nine patients with chronic rhinosinusitis were randomized in 2 operative groups (uncinectomy or balloon sinuplasty). Before and 6 months after the treatment, patients filled out a quality of life questionnaire (Sino Nasal Outcome Test-22 [SNOT-22]), and mucociliary clearance was measured with endoscope and gamma camera after 0.03 ml of saccharine, methylene-blue dye, and human albumin labeled with Tc99m was introduced to the bottom of maxillary sinuses. Results: In uncinectomy group, SNOT-22 score decreased, but treatment had no effect on mucociliary clearance. Based on saccharine test, smoking was associated with worse mucociliary clearance (r = 0.618, P < .05). Methylene blue test results associated with saccharine test (r = 0.434, P < .05) and Tc99m-labeled tracer technique (r = 0.261, P = .039) separately. Conclusion: Treatment positively affects patients’ quality of life; however, it has no effect on mucociliary clearance. There was a statistically significant correlation between the Tc99m-labeled tracer technique and the methylene blue technique. The saccharine technique was even less accurate, but it can be useful in clinical practice because it is a quick, easy, and safe technique. [ABSTRACT FROM AUTHOR]

Superior ophthalmic vein thrombosis (SOVT) is a rare, sight-threatening condition. It can be clinically challenging to distinguish from pre-septal cellulitis or cavernous sinus thrombosis. Imaging is often a key to identifying SOVT, and multi-disciplinary input is paramount to ensuring the optimum outcome. This often involves the paediatricians, ophthalmologists and paediatric neurologists if necessary. We report a case of a young boy with right SOVT that had initially been diagnosed as pre-septal cellulitis. A contrast-enhanced computed tomography scan was performed, as the patient developed limited eye movement on elevation, which showed dilatation of the right ophthalmic vein with pansinusitis. He was successfully treated with anticoagulation and antibiotics., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Elsaadawy et al.)

[english] Aim: To report a patient with unilateral exudative retinal detachment due to pansinusitis.Methods: Case report.Results: A 65-year-old woman with a two-month history of blurred vision, red eye and lid swelling in her left eye was referred to us. Her best-corrected visual acuity was 20/20 in the right eye and 20/200 in the left. Conjunctival vessels were engorged in the OS. Funduscopy revealed a 360° exudative detachment in OS and computerized tomography (CT) imaging revealed pansinusitis. Systemic antibiotic treatment was employed and exudative detachment regressed. However, exudative detachment remitted as soon as antibiotic treatment ceased. Finally she underwent sinus surgery and decompression of the orbita. Her visual acuity improved to 20/100 just two days after the surgery, stabilized at 20/30 and no further recurrences occured during the follow-up of 10 months.Conclusion: Since exudative retinal detachment usually accompanies systemic inflammatory or neoplastic diseases, systemic screening and collaboration with other disciplines are mandatory. To the best of our knowledge, this is the first report of a case that developed exudative retinal detachment due to pansinusitis and only recovered after decompression surgery.

To date Bordetella petrii has infrequently been identified within the clinical setting likely due to the asaccharolytic nature of this organism. We present a case of B. petrii recovered on two separate events in a patient with adult cystic fibrosis experiencing chronic pansinusitis.

Background: Intraorbital abscess is a very severe infection with ophthalmologic and neurologic complications that are sometimes life-threatening. Objective: To report the etiologic, clinical, radiologic, and prognostic features of one case of bilateral intraorbital abscesses with intracranial complications. Case report: A 15-year-old Cameroonian girl in a comatose state (11/15 on the Glasgow Coma Scale) with meningeal signs, right hemiplegia, right facial palsy, and bilateral exophthalmia was admitted for meningitis and cerebral abscess secondary to orbital cellulitis. A lumbar tap was carried out, no organisms were seen by Gram stain, and culture was negative due to previous antibiotic therapy. A computed tomography scan showed a left internal capsule infarct and a pansinus opacification. Bilateral superior orbitotomies were performed and the abscess evacuated. Microscopy and culture of surgical material were negative. The patient was discharged 4 weeks after hospital admission with a visual acuity of 0.1 in both eyes, aphasia, and right hemiplegia. Nine months later, there was complete visual recovery (visual acuity 1.0 in both eyes). Anterior and posterior segments were normal on slit-lamp examination. There was no aphasia, but right-sided hemiparesis persisted. Conclusion: The authors emphasize the need for prevention, early diagnosis, and adequate treatment of orbital cellulitis in order to avoid complications. [ABSTRACT FROM AUTHOR]

Abstract: Schizophillum commune has been increasingly reported from allergic bronchopulmonary mycosis (ABPM) as well as fungus ball, brain abscess and several cases of maxillary or allergic fungal sinusitis. In the present study, we reported a case of fungus ball type pansinusitis from a 32-year-old woman in Iran. According to computed tomography (CT) scan, fungus ball type pan-sinusitis was likely to be the first diagnosis. Mycological examination revealed hyaline hyphae with small projection and also clamp connection structures on PDA medium. To identify the obtained isolate properly, molecular analysis of the internal transcribed spacer region was performed and indicated that the causing agent of the infection is surely Schizophillum commune. The patient completely recovered after surgical endoscopic operation and consequent post-operation MRI revealed clearance of sinuses. [Copyright &y& Elsevier]

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A case of mucocutaneous sporotrichosis presenting as mycotic pansinusitis with polyposis with intracranial and intraorbital extension in a patient from Punjab, India is described. The patient had nasal discharge, sneezing and nasal obstruction for 12 years, had undergone repeated surgeries (for endoscopic clearance) but had recurrence. Computerized tomography (CT) and magnetic resonance imaging (MRI) findings revealed pansinusitis. A definitive diagnosis of sporotrichosis was established by culture ofSporothrix schenckii, verification of its dimorphic character and a positive pathogenicity test. The patient was successfully treated with potassium iodide and itraconazole. [ABSTRACT FROM AUTHOR]

This report describes a Sturge-Weber syndrome patient with recurrent pansinusitis and purulent nasal discharge. Radiological examination showed uncommon massive enlargement of the paranasal sinuses, in particular the frontal and maxillary sinuses. Computed tomography or magnetic resonance imaging is advised to distinguish between a vascular malformation or soft tissue overgrowth. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sinusitis is a rare cause of optic neuritis in children. This case illustrates bilateral optic neuritis in a 9-year-old child caused by pansinusitis. It demands an accurate diagnosis with a prompt management. A proper treatment of sinusitis is essential to prevent this complication. [ABSTRACT FROM AUTHOR]

A nine-year-old child was brought to the emergency room by her mother because of an upper respiratory infection symptoms and forehead swelling. The patient was seen by the emergency department physician and diagnosed with an upper respiratory infection; the forehead swelling was felt to be related to forceful coughing. The patient and patient's mother returned on a second visit because the forehead swelling had not improved. A CT scan of the head was subsequently done which demonstrated pansinusitis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Atta et al.)

Purpose: Upper eyelid ptosis has different etiologies in children and adults. In children, the common causes include orbital cellulitis, congenital ptosis, Cranial Nerve (CN) III palsy, and Horner's syndrome. The purpose of this report is to discuss an unusual presentation of ptosis., Observations: We describe a case of a 9-year-old boy with left-sided ptosis with no apparent clinical signs of orbital or preseptal infection. Magnetic resonance imaging (MRI) revealed pansinusitis and contralateral otitis media with direct extension into the superior aspect of the left orbit affecting the levator palpebrae superioris muscle., Conclusions and Importance: This finding on imaging disclosed the etiology of an otherwise unexplained case of upper lid ptosis.

Abstract: Lemierre''s syndrome is characterized by tonsillitis or peritonsilar abcess, a thrombophlebitis of the internal jugular vein, a bacteremia, and metastatic infections (most commonly, pulmonary abscesses) caused by the fusobacterium necrophorum. We report a case of a boy 4-year-old who in addition had a stenosis of the internal carotid artery as complication of the Lemierre''s syndrome. This syndrome is associated with a high mortality if the diagnostic and treatment are not realized promptly. [Copyright &y& Elsevier]