tommyk
10-04-2006, 05:45 AM
Hy 2409 What is this pathophys?
14-year-old girl named Anna Kournikova is brought to YOU in the ER because of generalized seizures lasting for 15 minutes. She has had purulent otitis for the last week, which has been poorly responsive to antibiotic treatment. Her temperature is 39.5 C (103 F), blood pressure is 128/80 mm Hg, pulse is 86/min, and respirations are 18/min. She appears oriented and cooperative during physical examination. Funduscopy reveals papilledema. The picture is a complication of sinusitis from…likely Strep. Pnemo. What IS the pathological process seen?
1-Cerebellar Abscess
2-Cerebral Abscess
3-Tonsillar Herniation
4-Cerebral Edema
a) Pick #2. One of the most serious complications of sinusitis and otitis is the development of cerebral abscesses. This often manifests with persistent fever, variable neurologic deficits, headache, and seizures. Because of the accompanying edema around the abscess, intracranial pressure may develop, which explains papilledema in this case. Cerebral abscesses are life-threatening conditions that often require surgical evacuation. Blood cultures are often negative in the case of an isolated cerebral abscess. On the other hand, the surgeon should submit samples for culture in case of surgical intervention. EEG studies may, at best, show non-specific (and thus non-diagnostic) focal changes in the temporal region. Lumbar puncture, as in all situations in which signs of increased intracranial pressure are detected, should be avoided.
14-year-old girl named Anna Kournikova is brought to YOU in the ER because of generalized seizures lasting for 15 minutes. She has had purulent otitis for the last week, which has been poorly responsive to antibiotic treatment. Her temperature is 39.5 C (103 F), blood pressure is 128/80 mm Hg, pulse is 86/min, and respirations are 18/min. She appears oriented and cooperative during physical examination. Funduscopy reveals papilledema. The picture is a complication of sinusitis from…likely Strep. Pnemo. What IS the pathological process seen?
1-Cerebellar Abscess
2-Cerebral Abscess
3-Tonsillar Herniation
4-Cerebral Edema
a) Pick #2. One of the most serious complications of sinusitis and otitis is the development of cerebral abscesses. This often manifests with persistent fever, variable neurologic deficits, headache, and seizures. Because of the accompanying edema around the abscess, intracranial pressure may develop, which explains papilledema in this case. Cerebral abscesses are life-threatening conditions that often require surgical evacuation. Blood cultures are often negative in the case of an isolated cerebral abscess. On the other hand, the surgeon should submit samples for culture in case of surgical intervention. EEG studies may, at best, show non-specific (and thus non-diagnostic) focal changes in the temporal region. Lumbar puncture, as in all situations in which signs of increased intracranial pressure are detected, should be avoided.