Diseases of PNS
A 2-year-old child with purulent nasal discharge, fever and pain since 2 months. His fever is 102-103°C, and leucocyte count is 12000 cu/mm. X-ray PNS showed opacification of left ethmoidal air cells. The culture of the eye discharge was negative. Which of the following woul'd be most useful further step in evaluation of this patient? [AIIMS Nov 2012]
|D||Repeat culture of the eye discharge|
The child is presenting with fever and purulent nasal discharge with X-ray PNS showing opacification of ethmoidal sinus, . probably the child is having chronic sinusitis (as it is present for the past 2 months) with an acute exacerbation. Now the most dreaded complication of ethmoidal sinusitis is orbital complication.
"Orbital complication - most of the complications, follow infection of ethmoids as they are separated from the orbit only by a thin lamina of bone -lamina papyracea. Infection travels from these sinuses either by ostitis or a thrombophlebitic process of ethmoidal veins."
- Dhingra 5th/ed p 213
The best method to assess the status of ethmoidal air cells and its complications is CT scan.
"Cl' is particularly useful in ethmoid and sphenoid sinus infections and has replaced studies with contrast material."
- Dhingra 5th/ed p 209