•Intracranial complications of acute bacterial rhinosinusitis include meningitis, brain abscess, subdural empyema and cavernous sinus thrombosis. Most common presenting feature of meningitis complicating sinusitis is seizure activity.
•IDSA encourages use of antibiotics for acute bacterial sinusitis when strict diagnostic criteria are met. Amoxicillin/clavulinateremains first line therapy.
NEONATAL VESICULAR RASH
•Many causes of vesicular rashes in the neonate are benign, but serious bacterial and viral infection must be evaluated.
•Neonatal scabies infestation presents with vesicular rash affecting the hands, feet, wrists and face of neonates. Treatment is with a single application of permethrin 5% cream, or 5-10% sulfur suspension in petroleum.
•Pancreatic cancer presents often in late stage due to vague symptoms of weakness, abdominal pain, diarrhea and jaundice.
•Recurrent visits for similar chronic complaints carry high risk. Consider serious pathology as underlying source.