ABSTRACT
With the ongoing development of the COVID-19 pandemic, research continues to emerge regarding the pathophysiology, characteristics, and treatment considerations for patients with COVID-19. No reports have highlighted the specific challenges posed in the management of pediatric patients with COVID-19 who present with complicated rhinosinusitis. In this report, we discuss our preoperative, intraoperative, and postoperative multidisciplinary treatment strategy for these cases and provide two examples of complicated rhinosinusitis cases in COVID-19 patients, treated with two different approaches. Pearls, insights, and a brief review of the literature are discussed.
Subject(s)
Coronavirus Infections/complications , Pneumonia, Viral/complications , Rhinitis/virology , Sinusitis/virology , Adolescent , Betacoronavirus , COVID-19 , COVID-19 Testing , Child , Clinical Laboratory Techniques , Combined Modality Therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/therapy , Humans , Male , Pandemics , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/therapy , Rhinitis/diagnostic imaging , Rhinitis/therapy , SARS-CoV-2 , Sinusitis/diagnostic imaging , Sinusitis/therapyABSTRACT
We review two cases of adolescents with orbital cellulitis, sinusitis and SARS- CoV-2 infection presenting to emergency departments within a 24 hour period. SARS-CoV-2 samples obtained within 24 hours were positive, supporting prior infection despite relatively limited early symptoms of COVID-19. Unusual clinical and radiographic characteristics included hemorrhagic abscess with blood of varying age in the first, intracranial epidural abscess in the second, radiographic signal consistent with hemorrhagic or thrombotic phenomena, retro-maxillary antral fat changes, and meningeal enhancement or extension in both cases. Radiographic findings thereby mimic fungal infection, although final cultures and ancillary investigation for allergic and invasive fungal disease have remained negative. These cases highlight two unusual orbital presentations of cellulitis occurring in the context of SARS-CoV-2 co-infection.