Brain abscesses caused by sinusitis are rare in the antibiotic era. The purpose of the current manuscript was to report a rare case of a brain abscess located mainly in the frontal lobe after sinusitis, which was initially thought to be meningitis or encephalitis. A 39-year-old man was transferred to our hospital from another neighbouring hospital with tonic-clonic seizures, severe headache, and purulent nasal secretions. For one week, he was taking antibiotics for sinusitis. The computed tomography indicated lesions in the right sinuses but not in the parenchymal brain and thus antibiotics along with antiepileptic drugs were given. However, due to the deterioration of symptoms, magnetic resonance imaging was executed, which revealed an abscess in the frontal lobe. Afterward, an anterior ethmoidectomy and middle maxillary antrostomy were performed in order to drain the purulent content from the right sinuses. Ten days later, the patient presented disorientation and thus an open craniotomy for successful removal of the parenchymal abscess was performed. One month later, the patient was discharged with mild irritability, which was eliminated gradually over the next two months. Conclusively, brain abscesses can be caused by local spread from an infection of the paranasal sinus. The contribution of imaging modality is very significant not only for the early diagnosis but also for the therapeutic management of such cases. Frequently antibiotic treatment is insufficient and surgery may be required.
Introduction: In the region of Epirus (Northwestern Greece) there are characteristic climatic and geographical conditions that facilitate the growth of typical vegetation with the production of allergic pollen. Aerobiological research into airborne pollen diversity and seasonal variation in pollen counts and fungi spores has become essential due to the growing incidence of allergic rhinitis, allergic asthma, and other pollen-related and spore-related allergic conditions. Furthermore, weather conditions and other factors like air pollution may affect the intensity, the onset, and the duration of the pollen season, and the impact on the patient's symptomatology. Methods: The diversity of airborne pollen grains (grains/m3) and fungal spores (spores/m3) in the region of Epirus were measured volumetrically using Burgard trap for 13 months, from May 1, 2017 to May 31, 2018. Results: Totally, 10 pollen families and two fungi were recognized. The six most common taxa were Cupressaceae, Pinaceae, Urticaceae, Poaceae, Betulaceae, and Compositeae. The fungi taxa were Cladosporium and Alternaria. Peak pollen centralization was recorded from May to September. Urticaceae had the longest pollen season while Oleaceae and Pinaceae had the shorter. Fungal spores were recorded during all the months of the year. Also, there was a correlation between meteorological parameters and most pollen taxa. Conclusion: The pollen and spore calendar shows the concentration of pollen grains and fungal spores in the region of Epirus. This knowledge is important for physicians and allergic patients as it could improve the management of the allergic respiratory disease.
In this paper, we present the case of acute airway obstruction due to tracheal carcinoma in a patient with glottic stenosis due to previously treated laryngeal carcinoma. Because of severe dyspnea from the obstructive endotracheal mass, tracheotomy under local anesthesia was immediately performed. Intubation with pediatric size (I.D. 4.5 mm) cuffed endotracheal tube was performed by the surgeon through tracheostomy under endoscopic visualization. Blakesley forceps and electrocautery were used for tumor debulking. Postoperatively there were no complications and the patient was discharged after four days. The histopathology report showed a squamous cell carcinoma. The tumor board decided on adjuvant chemoradiotherapy for the treatment of the patient.
Glanzmann thrombasthenia (GT) is an autosomal recessive platelet disorder that could cause mild to severe bleeding episodes. The incidence is approximately 1 per 1,000,000 births. Patients with GT frequently have mucocutaneous bleeding with absent platelet aggregation in response to all physiologic stimuli, but a normal platelet count and morphology. Specifically, the glycoprotein IIb/IIIa (GP IIb/IIIa) complex is either inadequate or dysfunctional. This case reports a 3.5-year-old boy with Glanzmann thrombasthenia who had two episodes with uncontrolled hemorrhage from upper digestive and respiratory tracts, the first with the bleeding point found in the left tonsil and the second in the adenoids.
Parapharyngeal space infections are uncommon but associated with significant morbidity and mortality. Early surgical drainage remains the mainstay of treatment; however, the optimal surgical approach continues to be debated. Management typically involves either an external (transcervical) approach or a transoral route. We present the case of a 43-year-old woman with a deep parapharyngeal abscess unresponsive to empirical antibiotic therapy who presented with dysphagia, fever, and left cervical swelling. Computed tomography (CT) confirmed the presence of the abscess. Ultrasound-guided intraoral drainage was performed, followed by intravenous antibiotic therapy. The patient had an uneventful recovery and was discharged on the sixth hospital day. Parapharyngeal abscess is the second most common deep neck space infection after peritonsillar abscess. Accurate diagnosis relies on clinical evaluation and radiologic imaging, with CT considered the gold standard for both initial diagnosis and ongoing monitoring.