An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report
Abstract Background Aspiration pneumonitis is an inflammatory disease of the lungs which is difficult to diagnose accurately. Large-volume aspiration of oropharyngeal or gastric contents is essential for the development of aspiration pneumonitis. The role of cerebrospinal fluid (CSF) rhinorrhea is o...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-07-01
|
| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-021-01620-5 |
| _version_ | 1818655593340076032 |
|---|---|
| author | Jiayu Cao Wei Liu Li Wang Yujuan Yang Yu Zhang Xicheng Song |
| author_facet | Jiayu Cao Wei Liu Li Wang Yujuan Yang Yu Zhang Xicheng Song |
| author_sort | Jiayu Cao |
| collection | DOAJ |
| description | Abstract Background Aspiration pneumonitis is an inflammatory disease of the lungs which is difficult to diagnose accurately. Large-volume aspiration of oropharyngeal or gastric contents is essential for the development of aspiration pneumonitis. The role of cerebrospinal fluid (CSF) rhinorrhea is often underestimated as a rare etiological factor for aspiration in the diagnosis process of aspiration pneumonitis. Case presentation We present a case of a patient with 4 weeks of right-sided watery rhinorrhea accompanied by intermittent postnasal drip and dry cough as the main symptoms. Combined with clinical symptoms, imaging examination of the sinuses, and laboratory examination of nasal secretions, she was initially diagnosed as spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, and intraoperative endoscopic findings and postoperative pathology also confirmed this diagnosis. Her chest computed tomography showed multiple flocculent ground glass density shadows in both lungs on admission. The patient underwent endoscopic resection of meningoencephalocele and repair of skull base defect after she was ruled out of viral pneumonitis. Symptoms of rhinorrhea and dry cough disappeared, and pneumonitis was improved 1 week after surgery and cured 2 months after surgery. Persistent CSF rhinorrhea caused by spontaneous sphenoid sinus meningoencephalocele was eventually found to be a major etiology for aspiration pneumonitis although the absence of typical symptoms and well-defined risk factors for aspiration, such as dysphagia, impaired cough reflex and reflux diseases. Conclusions We report a rare case of aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, which can bring more attention and understanding to the uncommon etiology for aspiration, so as to make more accurate diagnosis of the disease and early surgical treatment. |
| first_indexed | 2024-12-17T03:12:09Z |
| format | Article |
| id | doaj.art-b251dd03f1b046afb59c4dfa8dfb575a |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-17T03:12:09Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-b251dd03f1b046afb59c4dfa8dfb575a2022-12-21T22:05:48ZengBMCBMC Pulmonary Medicine1471-24662021-07-012111510.1186/s12890-021-01620-5An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case reportJiayu Cao0Wei Liu1Li Wang2Yujuan Yang3Yu Zhang4Xicheng Song5Department of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao UniversityDepartment of Physical Examination, Yantai Yuhuangding Hospital, Qingdao UniversityDepartment of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao UniversityDepartment of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao UniversityDepartment of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao UniversityDepartment of Otolaryngology-Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao UniversityAbstract Background Aspiration pneumonitis is an inflammatory disease of the lungs which is difficult to diagnose accurately. Large-volume aspiration of oropharyngeal or gastric contents is essential for the development of aspiration pneumonitis. The role of cerebrospinal fluid (CSF) rhinorrhea is often underestimated as a rare etiological factor for aspiration in the diagnosis process of aspiration pneumonitis. Case presentation We present a case of a patient with 4 weeks of right-sided watery rhinorrhea accompanied by intermittent postnasal drip and dry cough as the main symptoms. Combined with clinical symptoms, imaging examination of the sinuses, and laboratory examination of nasal secretions, she was initially diagnosed as spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, and intraoperative endoscopic findings and postoperative pathology also confirmed this diagnosis. Her chest computed tomography showed multiple flocculent ground glass density shadows in both lungs on admission. The patient underwent endoscopic resection of meningoencephalocele and repair of skull base defect after she was ruled out of viral pneumonitis. Symptoms of rhinorrhea and dry cough disappeared, and pneumonitis was improved 1 week after surgery and cured 2 months after surgery. Persistent CSF rhinorrhea caused by spontaneous sphenoid sinus meningoencephalocele was eventually found to be a major etiology for aspiration pneumonitis although the absence of typical symptoms and well-defined risk factors for aspiration, such as dysphagia, impaired cough reflex and reflux diseases. Conclusions We report a rare case of aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with CSF rhinorrhea, which can bring more attention and understanding to the uncommon etiology for aspiration, so as to make more accurate diagnosis of the disease and early surgical treatment.https://doi.org/10.1186/s12890-021-01620-5Aspiration pneumonitisMeningoencephaloceleSphenoid sinusEtiologyPostnasal drip |
| spellingShingle | Jiayu Cao Wei Liu Li Wang Yujuan Yang Yu Zhang Xicheng Song An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report BMC Pulmonary Medicine Aspiration pneumonitis Meningoencephalocele Sphenoid sinus Etiology Postnasal drip |
| title | An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report |
| title_full | An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report |
| title_fullStr | An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report |
| title_full_unstemmed | An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report |
| title_short | An uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea: a case report |
| title_sort | uncommon etiological factor for aspiration pneumonitis caused by spontaneous sphenoid sinus meningoencephalocele with cerebrospinal fluid rhinorrhea a case report |
| topic | Aspiration pneumonitis Meningoencephalocele Sphenoid sinus Etiology Postnasal drip |
| url | https://doi.org/10.1186/s12890-021-01620-5 |
| work_keys_str_mv | AT jiayucao anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT weiliu anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT liwang anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT yujuanyang anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT yuzhang anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT xichengsong anuncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT jiayucao uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT weiliu uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT liwang uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT yujuanyang uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT yuzhang uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport AT xichengsong uncommonetiologicalfactorforaspirationpneumonitiscausedbyspontaneoussphenoidsinusmeningoencephalocelewithcerebrospinalfluidrhinorrheaacasereport |