Pansinusitis-associated Superior Subperiosteal Abscess in An Adolescent: A Case Report

Subperiosteal abscess is a serious orbital complication of pediatric rhinosinusitis. Orbital complications from rhinosinusitis are uncommon but require prompt and effective treatment to prevent disastrous consequences such as permanent blindness. Our case demonstrated a rare but potentially hazardous orbital complication of untreated sinusitis. A 14-year-old boy presented with worsening right eye proptosis and profoundly reduced vision. Computed tomography (CT) of the brain, orbit and paranasal sinuses revealed a right superior subperiosteal abscess with pansinusitis. He received both medical and surgical treatment within 48 hours of admission, consisting of broad-spectrum intravenous ceftriaxone and metronidazole and emergency functional endoscopic sinus surgery (FESS). He improved tremendously upon completion of treatments. Prompt and aggressive treatment combining both surgical and medical approaches in treating superior subperiosteal abscess may be necessary to avoid morbidity.