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http://dx.doi.org/10.14776/piv.2019.26.e13

Epidural Abscess Caused by Eikenella corrodens in a Previously Healthy Child  

Kim, Ye Kyung (Department of Pediatrics, Seoul National University Children's Hospital)
Han, Mi Seon (Department of Pediatrics, Seoul National University Children's Hospital)
Yang, Song I (Department of Pediatrics, Seoul National University Children's Hospital)
Yun, Ki Wook (Department of Pediatrics, Seoul National University Children's Hospital)
Han, Doo Hee (Department of Otorhinolaryngology, Seoul National University Hospital)
Kim, Jae Yoon (Department of Pediatrics, National Medical Center)
Choi, Eun Hwa (Department of Pediatrics, Seoul National University Children's Hospital)
Publication Information
Pediatric Infection and Vaccine / v.26, no.2, 2019 , pp. 112-117 More about this Journal
Abstract
Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to $5.6{\times}3.4cm$ with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.
Keywords
Epidural abscess; Sinusitis; Eikenella corrodens;
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