NEJM额窦炎引起的硬膜外脓肿和头皮肿

?摘自年3月13日刊《新英格兰医学杂志》：

Apreviouslyhealthy13-year-oldboypresentedtotheotorhinolaryngologyclinicwithsoft,well-demarcated,painlessswellingoftheforehead(PanelA,arrow).Hehadnodefinitesymptomsofsinusitisbuthadhadaheadacheandfluctuatingfeverfor3weeks.Hehadnoneurologicdeficitorabnormalityonphysicalexamination.AbloodchemicalprofileshowedaC-reactiveproteinlevelof29mgperliterandawhite-cellcountof11,percubicmillimeter.Computedtomographyrevealedunilateralopacificationoftheleftfrontaland(PanelB,whiteandgreenarrows,respectively)aswellasdefectsinthefrontalbone(PanelB,bluearrow).T2-weightedaxialmagneticresonanceimages(MRIs)showedasubperiostealabscessintheforehead(PanelC,arrow)anda3cm×5cm×8cmepiduralabscess(PanelD,arrow).Therewasnoinvolvementofthevenoussinuses.A







































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