Intracranial Complications of Sinusitis in Childhood

1995 ◽  
Vol 104 (4) ◽  
pp. 288-293 ◽  
Author(s):  
Don N. Lerner ◽  
George H. Zalzal ◽  
Sukgi S. Choi ◽  
Dennis L. Johnson
Keyword(s):  
Medical Center ◽  
Abscess Formation ◽  
Intracranial Extension ◽  
Washington Dc ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
National Medical ◽  
Management Protocol ◽  
Similar Disease ◽  
Intracranial Complications

Complications of sinusitis in children, such as intracranial abscess formation, are uncommon and are often clinically unremarkable in comparison to similar disease processes in adults. Between 1983 and 1991, 443 children were admitted to Children's National Medical Center in Washington, DC, for treatment of sinusitis. Fourteen of these children presented with intracranial extension of the infection and abscess formation. A retrospective review of these patients revealed that the risk of developing an intracranial abscess secondary to sinusitis was 3%. The management of these patients included surgical drainage of the infected sinuses and intracranial surgical exploration. Cranialization and exenteration of the frontal sinus proved to be effective single-stage procedures. While not indicated in all patients, these procedures eliminated the sinus as a source of continued or potential infection and obviated the need for a second obliterative procedure. Combined antimicrobial therapy and surgical drainage should be the management protocol.

scholarly journals 1523. Clinical Epidemiology of Children with Orbital Cellulitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S554-S555
Author(s):  
Meghna Sharma ◽  
Alexandra Espinel ◽  
Emily Ansusinha ◽  
Rana F Hamdy
Keyword(s):  
Clinical Epidemiology ◽  
Medical Center ◽  
Orbital Cellulitis ◽  
Surgical Drainage ◽  
Medical Problems ◽  
Duration Of Symptoms ◽  
National Medical ◽  
Intracranial Complications ◽  
Almost All ◽  
Viridans Group Streptococci

Abstract Background The microbiology of pathogens causing orbital cellulitis in children is evolving over time, with studies from around 10 years ago describing MRSA as responsible for anywhere from 0 to 13% of cases of orbital cellulitis. However, the prevalence of community-acquired MRSA infections has declined over the past decade. A current understanding of the bacteria most commonly found to be responsible for orbital cellulitis would be important to inform the empiric antibiotic regimens for cases of orbital cellulitis in which no microbiologic data are available. Methods This is a single-center retrospective cohort study of children ≤18 years hospitalized with orbital cellulitis at Children’s National Medical Center between January 1, 2017 and July 31, 2018. We excluded children with immunocompromising conditions, cystic fibrosis, underlying craniofacial abnormality, or recent craniofacial or otolaryngologic surgery. Baseline clinical characteristics, microbiologic data, clinical outcomes, and antibiotic treatment data were abstracted through structured chart review and summarized with descriptive statistics. Results We identified 68 children that met inclusion criteria, with an average age of 8.2 years; 66.2% were male, 48.5% were African American, and 14.7% were Hispanic. Most (67.6%) had no underlying medical problems, 14.7% had asthma, and 22.1% had allergic rhinitis. The median duration of symptoms prior to presentation was 4 days. An abscess or phlegmon was identified in 41 of the 68 (60.3%). Three patients (4.4%) developed intracranial complications. About one-quarter (27.9%) of all patients in the cohort underwent surgical drainage. The most commonly identified pathogens were viridans group streptococci (7/19, 36.8%), followed by Staphylococcus aureus (4/19, 21.1%). Anti-MRSA therapy was provided empirically in almost all (95.6%) of patients. Conclusion One-quarter of all patients hospitalized for orbital cellulitis underwent surgical drainage, and viridans group streptococci and S. aureus were the most commonly isolated pathogens. While MRSA was isolated in only one patient (5.2%), almost all received empiric anti-MRSA therapy. Disclosures All authors: No reported disclosures.

scholarly journals The VP7 Genes of Two G9 Rotaviruses Isolated in 1980 from Diarrheal Stool Samples Collected in Washington, DC, Are Unique Molecularly and Serotypically

2008 ◽  
Vol 82 (8) ◽  
pp. 4175-4179 ◽  
Author(s):  
Dianjun Cao ◽  
Norma Santos ◽  
Ronald W. Jones ◽  
Masatoshi Tatsumi ◽  
Jon R. Gentsch ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Amino Acid ◽  
Amino Acid Sequence ◽  
Medical Center ◽  
Washington Dc ◽  
Sequence Analyses ◽  
National Medical ◽  
Lineage 2 ◽  
Stool Samples ◽  
Vp7 Gene

ABSTRACT In a retrospective study of archival diarrheal stool samples collected from 1974 to 1991 at Children's Hospital National Medical Center, Washington, DC, we detected three genotype G9P[8] viruses in specimens collected in 1980, which represented the earliest human G9 viruses ever isolated. The VP7 genes of two culture-adapted 1980 G9 viruses were phylogenetically related closely to the lineage 2 G9 virus VP7 gene. Unexpectedly, however, the VP7s of the 1980 G9 viruses were more closely related serotypically to lineage 3 VP7s than to lineage 2 VP7, which may be supported by amino acid sequence analyses of the VP7 proteins.

Letters to the Editor

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 465-466
Author(s):  
Itzhak Brook
Keyword(s):  
Antimicrobial Therapy ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Letters To The Editor ◽  
Ample Evidence ◽  
Complete Cure ◽  
Intracranial Complications

There is ample evidence to indicate that administration of antimicrobial therapy alone to patients with intracranial abscess can result in neurologic deterioration1 and higher mortality.2 In our article entitled "Complications of Sinusitis in Children" we described the occurrence of intracranial complications following sinusitis.3 Surgical drainage accompanied by antimicrobial therapy resulted, eventually, in complete cure of all of our patients. However, three out of four of our patients with intracranial abscess initially did not respond to appropriate antimicrobial therapy directed against the organisms recovered from their abscesses.

The Teaching of Crisis Counseling Skills to Pediatric Residents: A One-Year Study

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 907-911 ◽  
Author(s):  
Leslie S. Jewett ◽  
Larrie W. Greenberg ◽  
Lorraine A. A. Champion ◽  
Rita S. Gluck ◽  
Sanford L. Leikin ◽  
...  
Keyword(s):  
Medical Center ◽  
Washington Dc ◽  
Counseling Program ◽  
Crisis Counseling ◽  
Pediatric Residents ◽  
Information Giving ◽  
National Medical ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
One Year

Pediatric residents should learn to manage family crises such as informing parents that their child has a potentially life-threatening illness. Unfortunately, few training programs prepare residents to counsel parents of a child with cancer. An experiential parent crisis counseling program has been developed at the Children's Hospital National Medical Center in Washington, DC; this program has demonstrated that pediatric residents, with limited instruction, can be taught to give bad news to parents using effective information-giving and interpersonal skills.

scholarly journals Acute MRSA Sinusitis with Intracranial Extension and Marginal Vancomycin Susceptibility

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Parvathi S. Kumar ◽  
Kenji M. Cunnion
Keyword(s):  
Staphylococcus Aureus ◽  
High Risk ◽  
Inhibitory Concentration ◽  
Treatment Options ◽  
Subsequent Development ◽  
Intracranial Extension ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Acute Bacterial Sinusitis ◽  
Rifampin Resistance

Methicillin resistantStaphylococcus aureus(MRSA) is increasingly being described as a cause of acute sinusitis. We present a patient with acute MRSA sinusitis complicated by rapid intracranial extension, marginal vancomycin susceptibility (MIC = 2 mg/L), delayed drainage of intracranial abscess, and subsequent development of rifampin resistance. Given the relatively high risk of intracranial extension of severe acute bacterial sinusitis and high mortality associated with invasive MRSA infections, we suggest early surgical drainage of intracranial abscesses in these circumstances. We believe this is important given the limited intracranial penetration of currently available treatment options for MRSA, especially those with a vancomycin minimal inhibitory concentration (MIC) of ≥2 mg/L.

scholarly journals A qualidade de vida de jovens portadores de espinha bífida do Children's National Medical Center – Washington DC

2006 ◽  
Vol 11 (3) ◽  
pp. 817-826 ◽  
Author(s):  
Ana Helena Rotta Soares ◽  
Martha Cristina Nunes Moreira ◽  
Lúcia Maria Costa Monteiro ◽  
Hans G. Pohl
Keyword(s):  
Medical Center ◽  
Washington Dc ◽  
National Medical

O presente artigo tem como objetivo explorar a qualidade de vida de jovens portadores de espinha bífida atendidos no Children's National Medical Center em Washington DC. A pesquisa baseia-se em uma perspectiva qualitativa que utiliza como referencial teórico central a "Teoria do estigma" e as discussões conceituais sobre as dimensões de qualidade de vida. Foram entrevistados 15 jovens do serviço acima citado, sendo que 8 deles participaram de um grupo focal construído através das questões levantadas durante entrevistas. Os discursos dos jovens em questão refletem a necessidade de categorias mais englobantes que não remetam a uma pulverização da experiência de vida. Evidenciou-se uma estrutura de desigualdade nas interações entre saudáveis e deficientes, e reproduzida pelos próprios jovens. Os resultados demonstram que o estigma se encontra presente em todas as dimensões da vida dos sujeitos, interferindo na inserção social, construção subjetiva do jovem e sua auto-estima, reforçando o papel do portador de deficiência como uma "não-pessoa". Embora a categoria sexualidade não seja priorizada em outros instrumentos para esta população, o tema se faz presente e central na discussão da experiência da vida dos mesmos.

scholarly journals Family History of Autoimmune Disease in Patients with Aicardi-Goutières Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Johanna L. Schmidt ◽  
Ivana Olivieri ◽  
Jodie M. Vento ◽  
Elisa Fazzi ◽  
Heather Gordish-Dressman ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Medical Center ◽  
Family Members ◽  
Disease Diagnosis ◽  
Washington Dc ◽  
Chi Square ◽  
National Medical ◽  
History Of ◽  
Number Of Individuals ◽  
Syndrome Association

Purpose. The purpose of this study was to explore anecdotal evidence for an increase in the prevalence of autoimmune diseases in family members of patients with Aicardi-Goutières syndrome (AGS).Methods. Pedigrees of patients and controls were analyzed using chi-square and logistic regression to assess differences in reports of autoimmune disease among family members of cases and controls. Data was collected at Children's National Medical Center in Washington, DC, USA and at the International Aicardi-Goutières Syndrome Association Scientific Headquarters, C. Mondino National Institute of Neurology in Pavia, Italy.Results. The number of individuals with reported autoimmune disease is significantly related to having a family member with AGS (χ2=6.25,P=0.01); 10% (35/320) of relatives of patients with AGS had a reported autoimmune disease diagnosis compared to 5% (18/344) of relatives of controls. There was a greater percent of maternal relatives of patients with AGS reporting autoimmune disease (14.6%), compared to controls (6.8%), with the association being statistically significant. The association was not significant for paternal relatives.Conclusion. The prevalence of autoimmune disease in relatives of children with AGS is significantly increased compared to controls. More research is needed to better understand this association.

Intracranial Complications of Sinusitis in Children

1982 ◽  
Vol 91 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Itzhak Brook ◽  
Ellen M. Friedman
Keyword(s):  
Brain Abscess ◽  
Antimicrobial Therapy ◽  
Anaerobic Bacteria ◽  
The Other ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Periapical Abscess ◽  
Intracranial Complications ◽  
Maxillary Sinuses

The cases of two children with periapical abscess in the upper incisors, sinusitis, and intracranial abscess are described. The ethmoid and maxillary sinuses were involved in both patients. Subdural empyema occurred in both, and one of the children had also cerebritis and brain abscess. Anaerobic bacteria were isolated from the infected subdural empyemas. Peptostreptococcus intermedius and microaerophilic streptococci were recovered in one patient and Fusobacterium sp in the other. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in both patients. The role of anaerobic bacteria and the therapy directed against them in periapical abscess and the sinusitis and intracranial abscess which follow are discussed.

Health Characteristics of Elderly North Korean Defectors: 2006-2016 at National Medical Center

2019 ◽  
Vol 20 (1) ◽  
pp. 31-37
Author(s):  
Jong Yun Lee ◽  
Im Seok Koh ◽  
So Hee Lee ◽  
Sung Soo Eun
Keyword(s):  
Medical Center ◽  
National Medical ◽  
North Korean Defectors
Sign in / Sign up

Export Citation Format

Share Document