1. [Intracranial suppurations of otorhinolaryngological origin in children in Senegal].
- Author
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Passeron H, Sidy Ka A, Diakhaté I, and Imbert P
- Subjects
- Adolescent, Adrenal Cortex Hormones therapeutic use, Anti-Bacterial Agents therapeutic use, Bacterial Infections diagnosis, Bacterial Infections therapy, Brain Abscess diagnosis, Brain Abscess therapy, Child, Child, Preschool, Combined Modality Therapy, Cross-Sectional Studies, Disease Progression, Drainage, Empyema, Subdural diagnosis, Empyema, Subdural therapy, Female, Humans, Infant, Male, Neurologic Examination, Otitis Media, Suppurative diagnosis, Otitis Media, Suppurative therapy, Retrospective Studies, Senegal, Sinusitis diagnosis, Sinusitis therapy, Bacterial Infections epidemiology, Brain Abscess epidemiology, Developing Countries, Empyema, Subdural epidemiology, Otitis Media, Suppurative epidemiology, Sinusitis epidemiology
- Abstract
Background: Intracranial suppurations (ICSs) are poorly assessed in sub-Saharan Africa, especially in children., Patients and Methods: A retrospective study from 1st January 1996 to 31st December 2004 in children admitted to the pediatric department of the Hôpital Principal de Dakar, Senegal, for a sinogenic or otitic ICS. All cases were diagnosed by CT scan., Results: Sixteen children (12 boys and 4 girls), mean age of 11.2 years (range, 7-15 years), were admitted with the primary diagnosis of ICS. The mean time from the beginning of fever or neurological disorders to admission was 12 days (range, 1-60 days) and 6 days (range, 1-22 days), respectively. At admission, fever was noted in 14 patients and neurological signs in all patients. Otolaryngologic infections were sinusitis (n=14) or otitis (n=2). ICSs were subdural empyema (n=8), single (n=6) or multiple (n=1) cerebral abscesses, or association of subdural empyema and cerebral abscess (n=1). Bacteriological cultures were seldom positive because of frequent previous antibiotic therapies and showed Staphylococcus aureus (n=2), nongroupable Streptococcus (n=1), or Pseudomonas aeruginosa and Proteus mirabilis (n=1). Antibiotics were given initially intravenously for 30 days, then orally for 30 days. Additionally, some patients received corticosteroids (n=4) or phenobarbitone (n=9). Aspiration drainage of the ICS was undertaken in 13 patients. All the children were cured, 4 of whom had neurological sequelae at follow-up., Discussion: This pediatric series provides important data on the characteristics of ICS in sub-Saharan Africa. Therapeutic measures adapted to this context are proposed., Conclusion: Access to CT scan was fundamental in guiding medical and surgical management and ensuring a mostly favorable outcome despite long delays in treatment initiation., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
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