Sinugenic epidural empyema

Case contributed by Dr Faisal khalifah

Presentation

Bilateral otitis media not responding to antibiotics

Patient Data

Age: 15 months
Gender: Male
CT
  • Complete opacification of both mastoid air cells with rarefaction and bone defect seen at the lateral wall of the left mastoid bone associated with subcutaneous ring enhancing fluid collection seen adjacent to the left mastoid bone defect. 
  • Evidence of small epidural, limited by squamous suture, lentiform in shape, hypodense fluid collection with peripheral enhancement in the left temporal lobe at the same level of the left temporal subcutaneous abscess. However the separated bone appears to be intact apart from subtle thinning. 
  • No abnormal post contrast meningeal or dural enhancement. 

Case Discussion

Diagnosing an epidural abscess is important as may progress to meningitis, cerebritis or cortical venous thrombosis.

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Case information

rID: 64512
Published: 2nd Dec 2018
Last edited: 2nd Dec 2018
Inclusion in quiz mode: Included

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