Otogenic brain abscess as a complication of acute otitis media in an adult female patient – a case report and literature review

Abstract

<b>Introduction:</b>Ear abscess of the brain occurs in 0.3–1.3/100,000 of the population per year, and about 30% of abscesses are accompanied by other intracranial complications. Such complications can occur in the course of both chronic and acute otitis media, but the latter is extremely rare.<b>Aim:</b> To present a case of temporal lobe abscess in the course of acute otitis media (AOM) in an adult.<b>Case study: </b> The patient was admitted to the Hospital Emergency Department (ED) with symptoms of AOM with purulentleakage from the right ear and disturbance of consciousness. In addition to inflammatory changes in the middle ear, a CTscan showed zones of swelling in the right temporal lobe with suspicion of a forming temporal lobe abscess on the rightside. The treatment administered included urgent anthromastoidectomy and right-sided tympanostomy, as well as empiricalantibiotic therapy. Six days after admission, a follow-up magnetic resonance imaging (MRI) scan of the brain showedprogression of the lesions, complete formation of the abscess, and thrombotic changes in the cerebral venous sinuses werealso described. Further treatment included drainage of the temporal lobe abscess. A significant improvement in generaland neurological condition was achieved. Conservative treatment was continued and regression of the right temporal lobeabscess was achieved, and a follow-up RM study confirmed stable thrombotic lesions in the right transverse sinus.<b>Conclusions:</b> The occurrence of intracranial complications in the course of AOM in adults is extremely rare. Deterioration of the general condition and the appearance of consciousness disturbances in the course of AOM may indicate developing intracranial complications. Implementation of multidisciplinary diagnostic and therapeutic management makes it possible to achieve good therapeutic results.