Adolescent subdural empyema in setting of COVID-19 infection: illustrative case.

Autor:	Ljubimov VA; 1Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California., Babadjouni R; 1Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California., Ha J; 2Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, California., Krutikova VO; 3Touro University College of Osteopathic Medicine, Henderson, Nevada; and., Koempel JA; 4Division of Otolaryngology, Children's Hospital Los Angeles, Los Angeles, California., Chu J; 2Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, California., Chiarelli PA; 2Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2022 Jan 24; Vol. 3 (4). Date of Electronic Publication: 2022 Jan 24 (Print Publication: 2022).
DOI:	10.3171/CASE21506
Abstrakt:	Background: Coronavirus disease 2019 (COVID-19) is an ongoing viral pandemic that has affected modern medical practice and can complicate known pathology. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes symptoms that may mimic a viral pneumonia, with potential for serious sequelae, including acute respiratory distress syndrome, coagulopathy, multiorgan dysfunction, systemic vascular abnormalities, and secondary infection. Observations: The authors describe a case of a 15-year-old boy who presented with a right subdural empyema and sinusitis while having active COVID-19 infection. The patient initially presented with left-sided weakness, frontal sinusitis, and subdural empyema. Emergent surgery was performed for evacuation of empyema and sinus debridement. Samples of purulent material within the subdural space were tested for SARS-CoV-2 by reverse transcriptase polymerase chain reaction. The patient had a successful recovery and regained the use of his right side after combined treatment. To our knowledge, this is the first reported case of a bacterial subdural empyema associated with frontal sinusitis in a coinfected patient with COVID-19 without evidence of COVID-19 intracranial infection. Lessons: A subdural empyema, which is a surgical emergency, was likely a superinfection caused by COVID-19. This, along with the coagulopathy caused by the virus, introduced unique challenges to the treatment of a known pathology.
Databáze:	MEDLINE
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