S258 – Rapid Intracranial Spread of ENT Infection in B-thalassaemia

Abstract

Objectives 1) To find out the duration of onset of intracranial complications following middle ear and paranasal sinus infection in B-thalassaemia. 2) To find out the contributory factors for such complications. Methods A retrospective study of thalassaemic children who suffered from intracranial complication following ear and sinus infections between Jan '02- Oct '04, was done at a tertiary hospital Male', Maldives. Follow-up data were obtained from National Thalassaemia Centre. Patients' demographic pattern, thalassaemic status, Desferroxamine therapy, duration of the ear/nose symptom, the intracranial complications, the treatment and the outcomes were noted. We didn't include 3 patients, for whom full data were not available. Results We found the records of a series of 5 consecutive patients out of 94 thalassaemic patients which were referred with different ear and nose infections and were treated for intracranial complications. All patients were in the age group of 10–15 years. All were female. Spread of infection from the ear was more common than the spread from sinuses (3 out of 5 patients). The intracranial complications developed in these patients within few days (<5 days) of presentation in the clinic. All of the patients were on regular blood transfusion with desferroxamine therapy but none had spleenectomy. Most common organism found was klebsiella. Conclusions Persistent anaemia, repeated transfusion, iron overload, and hypersplenism are the major contributory factors for frequent infections in thalassaemics. Natural thinning of the bony cortex and remodelling of skull in thalassaemics can be considered as an additional factor for the rapid development of intracranial complications.