Brain abscess as an otorhinolaryngological complication

Abstract

Introduction: A brain abscess can be fatal if not diagnosed or treated promptly. It is more common in children than in adults and has a high mortality rate. Respiratory infections, such as otitis and sinusitis, usually precede brain abscesses. In most cases, double treatment, antibiotics, and surgery are necessary. Complications can be fatal even with proper treatment. Clinical case: This was a 3-year-old girl with a history of respiratory infection. His parents took her to the emergency room due to a severe headache and a seizure episode. Clinical examination revealed left ear otalgia associated with pain and sensitivity to palpation of the mastoid region. Laboratory tests revealed leukocytosis of 18,770/MMC with neutrophilia, thrombocytosis of 628,000/MMC, elevated C-reactive protein of 8.35 mg/dl (average value 0.10-0.30 mg/dl) and elevated ferritin of 250.20 ng/dl (standard value 7-140 ng/dl). Due to the patient’s history and clinical findings, the skull's computed tomography (CT) was performed, revealing an image of evident hypodensity in the left hemisphere. MRI was also performed and revealed that the lesion was previously associated with left breast thrombosis. She received antibiotics and low-molecular-weight heparin with neurosurgical therapy, which produced good results. Evolution: Despite the extent of the injury, he had two episodes of seizures. He promptly received appropriate antibiotic therapy and surgical treatment, which produced good results. Three months later, during the follow-up, he looked normal and had no long-term complications. Conclusions: Complications of brain abscess, even with adequate treatment, can be severe and include epilepsy or death. Early treatment minimizes lethal risks.