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{
    "pk": 1183,
    "title": "When a Headache Is More than the Flu: A Case Report",
    "subtitle": null,
    "abstract": "Introduction:\n When influenza (flu) season arrives, it is easy for emergency department clinicians to anchor on the diagnosis of flu, sending patients on their way with or without anti-influenza medication. It is important not to miss the outlier – the patient who seems to have typical symptoms of influenza but with certain subtleties that should make one consider expanding the differential diagnosis.\nCase Report:\n We describe an 11-year-old previously healthy male who presented with eight days of fever, myalgias, cough, congestion, and headache in the context of positive influenza exposure. The length and severity of his symptoms prompted laboratory and imaging investigation. He was positive for influenza type B with elevated inflammatory markers but otherwise normal laboratory workup and normal chest radiograph. He complained of a headache and was given fluids and antipyretics, and was admitted for overnight observation. He specifically did not have any forehead swelling. The next day during his inpatient stay he developed right frontal forehead edema and appeared ill. He was taken for a sinus computed tomography, which showed changes consistent with frontal bone osteomyelitis. Even after drainage by neurosurgery and otolaryngology, the patient subsequently developed repeat abscesses and ultimately a superior sagittal sinus thrombosis.\nConclusion:\n Other sources of infection should be considered in patients who have flu-like symptoms that last longer than expected, present with focality, or appear ill.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Pott’s puffy tumor"
        },
        {
            "word": "frontal bone osteomyelitis"
        },
        {
            "word": "influenza"
        },
        {
            "word": "case report"
        },
        {
            "word": "sinusitis"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8w32k9qw",
    "frozenauthors": [
        {
            "first_name": "Abigail",
            "middle_name": "E.",
            "last_name": "Russ",
            "name_suffix": "",
            "institution": "University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas",
            "department": "None"
        },
        {
            "first_name": "Amber",
            "middle_name": "M.",
            "last_name": "Morse",
            "name_suffix": "",
            "institution": "University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "M.",
            "last_name": "Spiro",
            "name_suffix": "",
            "institution": "University of Arkansas for Medical Sciences, Arkansas Children’s Hospital, Department of Pediatric Emergency Medicine, Little Rock, Arkansas",
            "department": "None"
        }
    ],
    "date_submitted": "2022-08-08T18:16:39Z",
    "date_accepted": "2022-08-08T18:16:39Z",
    "date_published": "2022-08-08T18:17:16Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1183/galley/922/download/"
        }
    ]
}