Eikenella corrodens rarely causes invasive
head and
neck infections in immunocompetent
children. We
report a case of
epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy
who presented with
fever,
headache, and
vomiting. On
physical examination upon admission, there was no
neck stiffness, but discharge from the right
ear was observed.
Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural
empyema on the right
temporal lobe as well as bilateral ethmoid and
sphenoid sinusitis, right
mastoiditis, and right
otitis media. During
treatment with
vancomycin and
cefotaxime, purulent
ear discharge aggravated, and on follow-up
brain MRI, the
empyema size increased to 5.6×3.4 cm with interval development of an
abscess at the right
sphenoid sinus. Burr hole
trephination was performed, and foul-smelling
pus was aspirated from the
epidural abscess near the right
temporal lobe.
Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive
pus drainage, and the same organism was grown. The
patient was treated with intravenous
cefotaxime for 3 weeks and recovered well with no other
complications. Therefore, E. corrodens can cause serious
complications in
children with untreated
sinusitis.