Case Report

Pansinusitis kronis dengan komplikasi abses serebri dan selulitis preseptal: laporan kasus

Iriana Maharani , David Santoso

Iriana Maharani
Departemen Ilmu Kesehatan Telinga Hidung Tenggorok-Bedah Kepala Leher, Fakultas Kedokteran, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, Indonesia. Email: iriana_maharani@ub.ac.id

David Santoso
Departemen Ilmu Kesehatan Telinga Hidung Tenggorok-Bedah Kepala Leher, Fakultas Kedokteran, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, Indonesia
Online First: July 15, 2021 | Cite this Article
Maharani, I., Santoso, D. 2021. Pansinusitis kronis dengan komplikasi abses serebri dan selulitis preseptal: laporan kasus. Intisari Sains Medis 12(2): 477-482. DOI:10.15562/ism.v12i2.1014


Background: Rhinosinusitis is an inflammation of the sinuses of the paranasal mucosa, while pansinusitis is an inflammatory process in several sinuses. Rhinosinusitis is one of the most prevalent health problems in the world. Although rare, rhinosinusitis can also lead to serious complications, including intracranial complications such as a cerebral abscess. This case report attempts to evaluate a cerebral abscess and preseptal cellulitis caused by chronic pansinusitis.

Case Presentation: A 56 years old woman, after trepanation, was consulted by the neurosurgery department to the ear, nose, throat, head, and neck department at dr. Saiful Anwar Hospital. Patients with complaints of decreased consciousness. A gradual decrease in consciousness was felt 3 weeks before admission to the hospital (SMRS). CT scan showed a cerebral abscess with a single lesion located in the frontal (unilocular) lobe as a complication of chronic pansinusitis. In this case, there was also preseptal cellulitis due to the spread of infection from the ethmoid sinus to the orbit. Treatment with ceftriaxone, metronidazole, omeprazole, ketorolac, Levemir, Apidra, Levocin, and anterior ethmoidectomy showed clinical improvement.

Conclusion: Cerebral abscess is a rare complication of chronic pansinusitis but has a high morbidity and mortality rate. Medical intervention and anterior ethmoidectomy showed clinical improvement in patients.

 

Latar Belakang: Rinosinusitis adalah peradangan sinus mukosa paranasal sedangkan pansinusitis merupakan proses inflamasi pada beberapa sinus. Rinosinusitis adalah salah satu masalah kesehatan yang memiliki prevalensi besar di dunia. Meskipun jarang terjadi, rinosinusitis juga dapat mengakibatkan komplikasi serius termasuk komplikasi intrakranial seperti abses serebri. Laporan kasus ini berupaya untuk mengevaluasi abses serebri dan selulitis preseptal yang disebabkan oleh pansinusitis kronis.

Presentasi Kasus: Seorang wanita berusia 56 tahun pasca trepanasi dikonsultasikan oleh departemen bedah saraf ke departemen telinga hidung tenggorok kepala leher (THT-KL) RSUD dr. Saiful Anwar Pasien dengan keluhan terjadi penurunan kesadaran. Penurunan kesadaran secara gradual dirasakan semenjak 3 minggu sebelum masuk rumah sakit (SMRS). Pemeriksaan CT-Scan menunjukkan keberadaan abses serebri dengan lesi tunggal yang terletak pada lobus frontalis (unilokuler) sebagai komplikasi pansinusitis kronis. Pada kasus ini juga didapatkan selulitis preseptal akibat penyebaran infeksi dari sinus ethmoidalis ke orbita. Pengobatan dengan pemberian ceftriaxone, metronidazole, omeprazole, ketorolac, Levemir, Apidra, Levocin, dan etmoidektomi anterior menunjukkan perbaikan klinis.

Kesimpulan: Abses serebri adalah komplikasi yang jarang pada pansinusitis kronis tetapi memiliki angka morbiditas dan mortalitas yang tinggi. Intervensi medikamentosa dan etmoidektomi anterior menunjukkan perbaikan klinis pada pasien.

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