Otogenic Brain Abscess: A Mini Review

Venkataramana Kandi

doi:10.7759/cureus.212

Abstract

Intracranial complications secondary to ear infections is an established clinical condition. The proximity of the brain compartments to the ear increases the chances of infections being percolated to central nervous system. Early clinical and laboratory diagnosis of such infections and better patient management strategies are required to minimize the intracranial and extracranial complications. Acute and chronic suppurative otitis media (CSOM) have been considered as risk factors for otogenic brain complications. Among the microbiological causes, recently there has been an increase in the cases of otogenic brain abscess due to Streptococcus spp . This review discusses the microbiological causes, implications, laboratory, diagnosis, and management of otogenic complications of central nervous system.

Highlights

BackgroundBrain abscess is defined as localized inflammation and infection of the brain parenchyma
The availability of non-invasive laboratory techniques for a better understanding of the involvement of brain parenchyma including the computed tomography (CT scan) and magnetic resonance imaging (MRI) of brain have been instrumental in better patient care and treatment outcome [4]
Otogenic brain abscess is defined as accumulation of pus in the cerebellum as a result of recurrent middle ear infection

Summary

Introduction

Brain abscess is defined as localized inflammation and infection of the brain parenchyma. Clinical symptoms during a brain abscess depend on the type and location of the lesion, extent of infection, type of microorganism involved, and the immune status of the patient. Otogenic brain abscess is defined as accumulation of pus in the cerebellum as a result of recurrent middle ear infection. The most common microbiological cause for otogenic cerebellar abscess was found to be Streptococcus spp, including the Enterococci as reported in the literature [22,23,24,25,26]. A recent study from India has reported that among the 57 cases of brain abscess, Streptococcus spp (36.8%) was the most common causative, followed by Staphylococcus aureus (22.8%) and Pseudomonas spp (5.2%) [27]. As many laboratories are ill-equipped to isolate anaerobic microorganisms, and since brain abscess may involve both aerobic and anaerobic microorganisms, it is suggested that antimicrobial chemotherapy should include antibiotics against anaerobic organisms [29,30,31]

Conclusions

Findings

Disclosures