Acute MRSA Sinusitis with Intracranial Extension in a 12 yr
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Introduction
Our patient, a previously healthy 12-year-old male, presented with acute MRSA sinusitis and rapid intracranial extension. The clinical case was complicated by a marginal vancomycin susceptibility (MIC = 2?mg/L), delayed drainage of intracranial abscess, and development of rifampin resistance. This case is illustrative of community-associated MRSA as a potential cause of acute sinusitis leading to intracranial extension, the challenges of antibiotic management of intracranial MRSA abscess, and the hazards of delayed drainage of intracranial MRSA abscess.

Case Presentation
A previously healthy 12-year-old male with a history of intermittent migraines was admitted with acute onset of altered mental status and facial swelling. The patient had symptoms of headache, “upset stomach,” increasing fatigue, and tactile fever for two days prior to admission. On the day of admission he was found to be minimally responsive with significant swelling to the left aspect of the face, yellowish discharge from the left eye, and a protuberance from the forehead. A noncontrast head CT scan done at an outside health care facility demonstrated bilateral orbital cellulitis, pansinusitis, and possible venous sinus thrombosis prompting transfer to a pediatric hospital....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784153/
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