Intracranial Complications of Sinusitis in Children. A Sequela of Periapical Abscess

The cases of two children with periapical abscess in the upper incisors, sinusitis, and intracranial abscess are described. The ethmoid and maxillary sinuses were involved in both patients. Subdural empyema occurred in both, and one of the children had also cerebritis and brain abscess. Anaerobic bacteria were isolated from the infected subdural empyemas. Peptostreptococcus intermedius and microaerophilic streptococci were recovered in one patient and Fusobacterium sp in the other. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in both patients. The role of anaerobic bacteria and the therapy directed against them in periapical abscess and the sinusitis and intracranial abscess which follow are discussed.