INTRODUCTION
Ethmoiditis is a frequent form of pediatric sinusitis and remains the most observed complication of rhinopharyngitis in children [1]. It can occur at a very young age, the ethmoidal sinus being already well developed and separated from the nasal cavities at birth [2]. During the first decade of life, acute sinusitis and especially ethmoiditis, are frequent. They represent 21% of all antibiotic prescriptions in pediatrics. Orbital involvement accounts for up to 91% of complications, with orbital and subperiosteal abscesses often leading to cavernous sinus thrombosis, meningitis, blindness, and intracranial abscesses. [3, 4]. Infection often spreads from the ethmoidal sinus into the periorbital spaces through the bloodstream or via erosion of the lamina papyracea.
When a subperiosteal orbital abscess (Chandler stage III) develops, surgical drainage is mandatory in addition to intravenous antibiotics.
We present a 14-year-old girl with acute ethmoiditis complicated by cerebral empyema, cellulitis, and intraorbital abscess.
Medical and surgical treatment resulted in a gradual and rapid resolution of symptoms while maintaining neurological and visual integrity.