Evaluation of Pediatric Preseptal Cellulitis Cases Diagnosed with Meningitis by Magnetic Resonance Imaging

Özet

Rhinosinusitis is a common infection and may rarely cause severe life-threatening orbital and intracranial complications. In thisstudy, two cases with preseptal cellulitis and meningitis as a complication of rhinosinusitis were presented in the light of the literature. A nine years and two months old girl was admitted with complaints as fever, redness and swelling in the left eye. Physicalexamination revealed erythema and edema in the left lower and upper eyelids, and the eye movements were painless and normalin all directions. Her systemic examination was normal and there was no sign of meningeal irritation. Magnetic resonance imagingrevealed ethmoid, frontal and sphenoid sinusitis and left cerebral hemisphere dural meningeal contrast enhancement. The patientwas diagnosed with meningitis after lumbar puncture. After 14 days of appropriate antibiotic treatment, the patient recovered andwas discharged. An eight years and five months old boy presented with fever, redness and swelling in the left eye was admitted.There were erythema and edema in the left lower and upper eyelid; the eye movements were painless in all directions and werecomplete. Systemic examination was normal; there was no sign of meningeal irritation. Pansinusitis and preseptal cellulitis findings were detected on computer tomography. The patient's fever persisted under treatment and erythema and edema of the eyebecame more evident. Orbital MRI was performed considering the complication and contrast enhancement was observed in theleft frontal region. The patient was diagnosed with meningitis after lumbar puncture. After 14 days of appropriate antibiotic treatment, the patient recovered and was discharged. Intracranial complication due to preseptal sinusitis is rare but life-threatening. Inthese cases, we recommend the use of MRI as the radiological imaging method.