Nocardia nova sphenoid sinusitis and infratemporal fossa abscess

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• 作者：A. Giordano ; M. Cohen-Salmon ; B. Joly ; ^{Bertrand.joly@ch-ajaccio.fr" class="auth_mail" title="E-mail the corresponding author} ; C. Maffiolo
• 关键词：Sphenoid sinusitis ; Nocardia ; Headache ; Meningeal abscess
• 刊名：European Annals of Otorhinolaryngology, Head and Neck Diseases
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：133
• 期：2
• 页码：125-127
• 全文大小：652 K

文摘

Nocardia sinusitis is exceptional, as a Medline search revealed only one published case. The authors report a case of sphenoid sinusitis complicated by infratemporal fossa abscess, which raised several diagnostic problems.

Case report

The patient was referred with temporal headache, subacute trigeminal neuralgia and subsequent infectious syndrome. Computed tomography imaging revealed left sphenoid sinusitis with osteolysis and infratemporal fossa abscess, as well as suspicious lung nodules suggestive of the initial site of infection. Bacteriological specimens obtained by endoscopic sphenoidotomy confirmed the presence of Nocardia nova. A favourable outcome was observed in response to targeted antibiotic therapy.

Discussion and conclusion

Sphenoid sinusitis with infratemporal fossa abscess is an exceptional mode of presentation of nocardiosis, illustrating the polymorphic clinical features of this disease. Bacteriological examination of samples taken directly from the organ concerned, in this case, by sphenoidotomy, is the only formal diagnostic criterion. Antibiotic therapy with intravenous imipenem/amikacin, followed by oral sulfamethoxazole/trimethoprim (Bactrim Forte^®) for several months, is the key to successful management.