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Unilateral frontal sinusitis with bilateral frontal lobe abscess

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BACKGROUND. Complications of rhinosinusitis are rare due to the widespread use of antibiotics. The complications are most commonly seen in young adults due to the presence of highly vascular diploic veins and are relatively infrequent in the elderly population.

CASE REPORT. We present a case of a 70-year-old male admitted to ENT Outpatient Department with chief complain of fever, headache, blurring of vision. The cranio-cerebral MRI revealed fluid collection in the left frontal sinus and in the bilateral frontal lobes. A diagnosis of frontal sinusitis and bilateral frontal lobe abscess was established. We performed endoscopical surgical drainage of the frontal sinus, with pus evacuation and we administered broad-spectrum antibiotic and systemic corticosteroids therapy for 14 days.

CONCLUSION. Rhinosinusitis with intracranial complication in elderly people is scarce to find because of less chance of sinus and middle ear infection and also because of less vascular diploic veins. Also, there may be no history or previous symptoms of sinusitis. A high index of suspicion with early surgical and medical intervention are utmost important in the management of these patients.