An 8-year-old previously healthy patient presented to the emergency department with a 7-day history of fever, pain in the right glueal region, and pain in the previous 48 h.
An abscess in that area was diagnosed by ultrasound and admitted for drainage and antibiotic therapy.
It also presents mild nasal obstruction, serous rhinorrhea, nostrils and erythematous nostrils, which is interpreted as a nonspecific inflammatory condition of the upper airway.
Located foruncle in a nasal vestibule that had drained spontaneously 4 days prior to consultation.
Laboratory tests showed leukocytosis with neutrophilia and high erythrocyte sedimentation rate.
It is empirically medicated with intravenous cephalothin and gentamicin (IV).
On the second day of hospitalization there was a progressive increase in nasal obstruction, edema of the dorsum of the nose and mucosal congestion, with purulent rhinorrhea and severe frontal headache.
History of recurrent skin infections in several relatives was recorded.
To add dexamethasone and the evolution of the clinical picture, antibiotic scheme was rotated to clindamycin 40 mg/kg/day EV and cefotaxime 150 mg/kg/day EV to cover Staphylococcus aureus upper colon
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X-rays of the sinuses showed signs compatible with mucosal edema.
Computed tomography (CT) of the craniofacial mass showed altered permeability of the nasal cavity due to significant mucosal thickening, with changes in the frontal and frontal lobes and frontal lobes showing cell density.
Orbital or nervous system involvement was ruled out.
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Bilateral AN was diagnosed and surgically drained, with bilateral anterior taping.
Staphylococcus aureus MR-CO was isolated from the culture of the material obtained.
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On the 3rd postoperative day, the anterior packing was removed and corticoid and cefotaxime were suspended according to the antibiogram.
Forty-eight hours later, the patient presented increased edema and frontal headache.
Overinfection with non-isolated germs in culture and sinus involvement was suspected; cefotaxime was added to the antibiotic regimen.
CT was repeated, revealing obliteration of the lumen of the nostrils, with edema of soft tissues; a new collection was discarded.
The glue abscess is successfully drained surgically and the same etiologic agent is isolated.
She received 14 days of IV antibiotics with oral trimethoprim-metaloxazole and amoxicillin-clavulanate (VO) for 21 days.
