Preseptal Cellulitis and Subdural Empyema as a Complication of Frontal Sinusitis

Acute bacterial sinusitis in children can be complicated by orbital or periorbital cellulitis, and epidural, subdural, or brain abscesses. Despite advances in imaging and the availability of antibiotics, subdural empyema remains a disease process that carries significant morbidity and mortality. Subdural empyema is usually accepted as a neurosurgical emergency that requires drainage. However, prompt initiation of proper antibiotics with close observation and follow-up of the patient saves the patient from invasive cranial and sinus surgery and their potential complications. Early diagnosis and proper treatment (including surgery where needed) decrease mortality in patients with this disease.We report a 12 years old male patient who developed periorbital cellulitis and left sided subdural empyema and was healed by prompt institution of proper antibiotics without surgery.