Subdural empyema in immunocompetent pediatric patients with recent SARS-CoV-2 positivity: case report.

Subdural empyema refers to the collection of purulent material in the subdural space and the most source of it is bacterial meningitis in infants while sinusitis and otitis media in older children. It has been very recently reported that coronaviruses (CoV) exhibit neurotropic properties and may also cause neurological diseases. CoV-related complications as hypercoagulability with thrombosis and associated inflammation, catastrophic cerebral venous sinus thrombose sand bacterial-fungal superinfections have been well documented in adult patients. Hereby, we describe 15-year-old and 12-year-old female children with subdural empyema after SARS-CoV2. The patients presented limitation of eye in the outward gaze, impaired speech, drowsiness, fever, vomiting and they also were tested positive for COVID-19. MRI indicated subdural empyema and surgical interventions were needed to relieve intracranial pressure and drain pus after receiving broad spectrum antibiotics treatments. The microbiological analysis of abscess material revealed Streptococcus constellatus which is extremely rare in an immunocompetent child and the patients received appropriate IV antibiotic therapy. Eventually, patients became neurologically intact. Pediatric patients with CoV infections should be closely monitored for neurological symptoms. Further research and more data on the correlation between CoV infections would provide better recognition and treatment options in an efficient manner in children.

Important Finding for COVID-19 Pandemic; Hydrocephalus producing effect of Vaporised Alcohol Disinfectant.

BACKGROUND: Alcohol exposure may cause hydrocephalus. In this study, the effect of vaporized nasal alcohol exposure on the choroid plexus, ependymal cells, and developing hydrocephalus was investigated. METHODS: 24 males (∼380g) Wistar rats were used in this study. Animals were divided into three groups, as the control, SHAM and study groups. Then, the study group was again divided into two groups as exposed to light or heavy dose alcohol. The choroid plexuses and intraventricular ependymal cells and ventricles volumes were assessed and compared. RESULTS: Degenerated epithelial cells density 22±5 /mm3 in the control group, 56±11 /mm3 in the SHAM group, 175±37 /mm3 in the light, and 356±85 /mm3 in the heavy alcohol exposure group. Evan's index was less than <34% in the control, larger than >36% in the SHAM, larger than >40% in the group which was exposed to light alcohol (light alcohol group), larger than >50% in heavy alcohol (heavy alcohol group) exposed. CONCLUSIONS: It was found that alcohol exposure causes choroid plexus and ependymal cell degeneration with ciliopathy and the enlarged lateral ventricles or hydrocephalus. In the COVID-19 Pandemic Era, our findings are functionally important; alcohol has often been used for hygiene and prevention of transmission of COVID-19 pandemic.