Otogenic Brain Abscess Research Articles

Otogenic brain abscess and concomitant acute COVID 19 infection - case report and review of the literature.

COVID-19 has attracted global attention primarily because of the severe acute respiratory symptoms associated with it. However, nearly one third of the patients also present with neurologic symptoms. This report describes a case of a previously healthy woman with acute COVID-19 infection, who developed acute facial nerve palsy and rapid progression to coma due to otogenic brain abscess. A 63-year-old woman with acute COVID-19 infection exhibited acute facial nerve paresis, high fever and purulent secretion from her left ear within 48 hours after COVID-19 onset. Cranial CT scan confirmed acute mastoiditis, precipitating an urgent mastoidectomy. A postoperative contrast-enhanced MRI on the same day revealed a subdural empyema, which prompted an urgent craniotomy and decompression. Intraoperative microbiological swabs confirmed a Streptococcus pyogenes infection, however RT-PCR was negative for SARS-CoV-2. After immediate i.v. antibiotic treatment, extubation was achieved four days post-operation, and the patient was discharged without neurologic deficits 19 days after postoperatively. This finding adds a layer of insight into the specific nature of the infection, suggesting a potential absence of SARS-CoV-2 involvement in otogenic subdural empyema. However, the impact of SARS-CoV-2 in otogenic brain abscess cannot be excluded to date and should be further prospectively investigated. The complete recovery of neurological status, emphasizes the importance of prompt and interdisciplinary interventions in managing rare and severe complications associated with COVID-19.

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

<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.

Akut mastoidite ikincil nadir görülen bir otojenik beyin apsesi tablosu

Otogenic brain abscess, precipitated by acute mastoiditis, is a rare but potentially fatal condition. It constitutes an intracranial complication that can further develop due to meningitis and sigmoid sinus thrombosis. This case underscores the critical importance of early detection and therapeutic intervention, which often pose substantial clinical challenges. This report elucidates the case of a 35-year-old female who arrived with severe otalgia, noted predominantly on the right side, coupled with discharge and vertigo. Subsequent neuroimaging unveiled the presence of basal meningitis in the right cerebellar hemisphere, accompanied by an extradural abscess and coalescent mastoid air cells. The patient's treatment protocol entailed a rigorous antibiotic regimen, continually adjusted based on symptomatic improvement. The rapid diagnosis and immediate treatment of otogenic brain abscesses are paramount. As observed in our case, factors such as limited medical knowledge, oversight in medical care, and socio-economic disadvantages contributed to the severity of the intracranial complication. These elements highlight the necessity of addressing systemic factors in healthcare to ensure effective prevention and management of such conditions.

Clinical analysis, diagnosis, and treatment strategies for otogenic brain abscesses.

Objective: To explore the clinical features, diagnosis, and treatment strategies for otogenic brain abscesses (OBA). Methods: Clinical data from 10 patients with OBA were analyzed retrospectively. Clinical characteristics, diagnosis, and treatment experiences were summarized. Results: Two were first diagnosed in the Department of Otorhinolaryngology, 5 in Neurosurgery, and 3 in other departments. There were 6 cases of temporal lobe abscess and 4 cases of cerebellar abscesses. Five cases were accompanied by 1 or more intracranial complications. Headache is a common presentation in all cases. The main pathogenic bacteria were anaerobic bacteria. All patients had no previous ear or brain surgery history, and no history of traumatic brain injury, 7 received surgical treatment in the neurosurgery and/or otolaryngology department. Two patients died, the other 8 fully recovered and so were discharged. Conclusions: Diagnosis and treatment of OBA must involve multiple departments. Multidisciplinary consultation (MDT) is crucial to the success of the first OBA diagnosis. The diagnosis and treatment team develops personalized treatment plans by integrating MDT treatment opinions and combining the actual condition of patients, thereby making the diagnosis and treatment of OBA accurate and timely.

Otogenic Brain Abscess in a Child of Third World Country - A Single Stage Transcranial Transmastoid Approach: A Case Report

Brain abscess, though not rare, is an uncommon complication of otitis media. We report a case of 12 years old male for chronic ear discharge, throbbing headache and post aural swelling for three weeks. A detailed history and physical examination of the child was performed and a Magnetic Resonance Imaging (MRI) scan was done. A diagnosis of an intracranial abscess, secondary to the chronic otitis media was made. An emergency craniotomy with drainage of brain abscess was planned and performed by the Neurosurgeon. Otolaryngolgoist performed mastoidectomy, in the same setting. After the surgery, post-operative manage- ment was done and the patient was discharged, uneventfully. The complete management in a single sitting of primary cause and resulting complication with no added expenses is the necessity of a poor country citizen.

Actinomyces europaeus (Gleimia europaea) asociado con absceso cerebral: comunicación de tres casos

A brain abscess is a focal infection characterized by a collection of pus in the brain parenchyma. It is a life-threatening condition that should be diagnosed and treated as soon as possible. We report here three cases of patients with otogenic brain abscesses of polymicrobial origin that had in common the isolation of Actinomyces europaeus, which has not been previously described in this location. A. europaeus was identified by the conventional methodology, matrix-associated laser deionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene sequencing. Antibiotic susceptibility was evaluated by the epsilometric method, and all isolates showed sensitivity to penicillin, vancomycin and linezolid, whereas susceptibility to clindamycin and erythromycin was variable. MALDI-TOF MS identification allowed a quick and reliable species level identification in order to provide a rapid and effective response to avoid treatment delay that could lead to increased morbidity and even mortality.

Otogenic Cerebellar Abscess with Cholesteatoma

Otogenic brain abscesses are the second-most common intracranial complication observed in patients of chronic otitis media, more frequently occurring with cholesteatoma. Due to the availability of antibiotics and advanced imaging techniques, the incidence and mortality of otogenic brain abscesses has reduced. Nevertheless, we still come across cases of otogenic brain abscess in modern times. Here, we report a case of the left ear chronic otitis media, squamosal type with intracranial complication of the left cerebellar abscess in a 14-year-old girl. Magnetic resonance imaging of the brain showed a thick-walled cystic lesion in the left cerebellar hemisphere measuring 41 mm × 28 mm × 26 mm suggestive of brain abscess. High-resolution computed tomography of the temporal bone showed soft-tissue density in the left mastoid air cells, in epitympanum, and mesotympanum encasing the left middle ear ossicular chain, suggestive of chronic otomastoiditis with possible underlying cholesteatoma. The patient underwent left retromastoid suboccipital craniotomy and excision of brain abscess followed by the left modified radical mastoidectomy 1 month later. Follow-up scan at 6 months showed no recurrence or any residual disease. Hence, timely surgical intervention for complicated chronic otitis media gives satisfactory results.

Case Report: Management of Chronic Supurative Otitis Media Cholesteatoma Type with Recurrent Brain Abscess Complication

Introduction: Chronic suppurative otitis media is broadly defined as chronic inflammation that involved mucose of middle ear and mastoid air cells. The most commonly encountered intracranial complication from chronic suppurative otitis media is meningitis followed by brain abscess. Antibiotics are quite effective in early and late cerebritis stage. Surgical intervention is essential once the abscess’s capsule is formed. Case Report: Reported a case of a 22-year-old male diagnosed with chronic suppurative otitis media auris dextra suspected cholesteatoma type with cerebral abscess complications. The managements are cerebral abscess drainage followed by canal wall down mastoidectomy. In patient, Recurrent cerebral abscess formed. Conclusion: Chronic suppurative otitis media with complications of cerebral abscess is treated with abscess drainage if the abscess size is >2cm and followed by canal wall down mastoidectomy. Otogenic brain abscess due to chronic suppurative otitis media can occur repeatedly if abscess antibiotic therapy was/were inadequate
 Keywords: otogenic brain abscess, mastoidectomy, chronic suppurative otitis media, abscess drainage

Diagnosis of otogenic brain abscesses Folia Otolaryngologica orientalia. B. 1-1932

Diagnosis of otogenic brain abscesses. According to Rejto (Folia Otolaryngologica orientalia. B. 1-1932, Herusalem) in the treatment of brain abscesses of otogenic origin, early diagnosis plays an important role. Despite the relative prevalence of this disease, its diagnosis is most often established on the operating table, when, after opening the cranium, the operator finds a convex, injected, altered part of the dura mater.

Rare Case Report: Serratia Liquefaciens and Enterococcus Species as a Cause of Otogenic Brain Abscess Secondary to Active Epithelial Chronic Suppurative Otitis Media (CSOM) in a 12-Year Old Male Patient with Hemiparesis

Developing countries face the problem of Otogenic intracranial complications especially in paediatric population because of poor hygiene, malnutrition and low immunity. Active epithelial type Chronic Suppurative Otitis Media (CSOM) can be the cause of potentially fatal complications. One of these is otogenic brain abscess. Having an estimated annual incidence to be approximately 0.5 per 100,000 children, it is associated with high mortality. We describe a unique case of otogenic brain abscess secondary to Active epithelial CSOM being neglected for two years and finding an unexpected foreign body in the right ear canal in a 12-year-old boy. The consultation was sought when the headache became intense and hemiparesis appeared. Our case is unique regarding both the clinical presentation and the causative organism. The patient underwent craniotomy, with elective capsulotomy, drainage of abscess and placement of a ventriculoperitoneal shunt. This was followed by a modified radical mastoidectomy two weeks later and an uneventful recovery.

Smell for some lorrhea diseases

The state of smell was determined in chronic tonsillitis, rheumatism, acute catarrh of the upper respiratory tract, influenza, sinusitis, vasomotor rhinitis, curvature of the nasal septum, otogenic brain abscess, otitis media, concussion. For the study, we used the olfactometers developed by us, into which air is pumped by an air blower and further through the tube enters the respiratory tract of the subject. In the device, a different concentration of an odorous substance necessary for research is created. The subject has a sensation of smell and its disappearance.

Otogenic brain abscess – a case report

Otogenic intracranial complications - although less common than before - should always alert otolaryngologists and other specialists, including those in the field of outpatient healthcare. Due to their life-threatening consequences, early detection and appropriate management, including surgical treatment, is crucial for a prompt recovery. Below we present a case of a patient in whom the brain abscess has progressed despite the surgical treatment, and describe what strategy was adopted and what followed its choice.

Pseudomonas Pseudoalcaligenes Caused Otogenic Cerebellar Brain Abscess In Indonesian Child

Otogenic brain abscess is a common intracranial complication from chronic supurative otitis media.Pseudomonas pseudoalcaligenes is a rare cause of brain abscess. Prompt diagnosis and decision making issignificant in order to decrease the mortality rate from this type of abscess. We described A 13-year-old boypresented with decreased consciousness, positive meningeal signs, and pathological reflexes. There was ahistory of chronic suppurative otitis media. A head CT scan revealed multiple left cerebellar abscesses andbrain edema. The abscess wall culture revealed P. pseudoalcaligenes. After being managed with surgicalabscess drainage, mastoidectomy, ear flushing, and antimicrobial therapy for six weeks, his consciousnesslevel improved. Cerebellar neurological impairment was still observed. Physical and neurologicalrehabilitation was performed in order to improve the patient’s condition.

Right hemiparesis caused by massive otogenic brain abscess in children: Unusual case report and review of the literature

IntroductionHemiparesis caused by otogenic brain abscess in children is an unusual complication of Chronic Suppurative Otitis Media. Complications can occur when the disease is not treated properly so that the infection in the middle ear spreads intracranially.Case presentationWe report a case of Chronic Suppurative Otitis Media with cholesteatoma in a 14-year-old boy with complications of right hemiparesis caused by an otogenic brain abscess. His management included open craniotomy, drainage of the abscess, radical mastoidectomy and intravenous antibiotics according to the result of the culture and sensitivity.Clinical discussionCommonly, the location of the abscess is closely related to the source of infection. Affected brain lobes usually depend on predisposing factors that cause the development of brain abscesses. In this case, clinical manifestations appear in the form of contralateral hemiparesis even though the source of infection comes from the ear. This can occur due to massive abscesses and the presence of extensive perifocal edema which results in pressure in the subcortex area. The patient underwent radical mastoidectomy in conjunction with an abscess excision craniotomy.ConclusionHemiparesis caused by an otogenic brain abscess is unusual. Rapid and precise diagnosis and treatment can minimize patient mortality and morbidity.

Incidence and Predisposing factors of Brain Abscess in Children at a Tertiary Care Center Dera Ghazi Khan

Objective: A cross sectional study was aimed to investigate the incidence and predisposing factors of brain abscess in children.
 Material and Methods: The study was conducted in the departments of Neurosurgery and Pediatric Surgery, Ghazi Khan Medical College and Hospital DG khan. Thirty two children with brain abscess were enrolled in the study. A diagnosis of brain abscess was made on clinical and radiological basis. T-test and chi square were applied to see the association between variables.
 Results: Most common location of Abscess was found as frontal in 21.9% patients, temporo parietal in 53.1% patients and occipital in 25.0% patients. Streptococci was the most common microorganism on culture reported, noted in 46.9% patients. Major predisposing factors (p = 0.000) and location of abscess (p = 0.003) were the effect modifiers for microorganism on culture reports.
 Conclusion: Streptococci was the most common abscess causing microorganism causing about 47% of total abscess causing pathogens. Main predisposing factors were: otitis media, cyanotic heart disease and post head injury otorrhea.
 Keywords: Brain abscess; Children; Otogenic brain abscess; Otitis media, Seizures; Streptococci.

OTOGENIC BRAIN ABSCESS MANAGEMENT STRATEGY : AN INSTITUTIONAL EXPERIENCE.

Abstract: Otogenic brain abscess is a potentially lifethreatening complication of otitis media, which requires a high index of suspension for prompt diagnosis and management. This study is a retrospective analysis of 20 cases of otogenic brain abscess that has been managed at our institute from 2000 to 2018. Although the prevalence has decreased signicantly due to the use of antibiotics, the problem still persists. Headache, fever and vomiting are the most common presenting symptoms. The use of advanced imaging techniques has contributed a lot in making the diagnosis faster. In contrast to previous studies where the temporal lobe is the most common site, both cerebellar and temporal lobe involvement has been seen to occur equally among our study population. . Pseudomonas was found to be the most common organism as compared to Proteus mirabilis in most of the recent studies. Immediate therapy with intravenous antibiotics was found responsible for 32% of the sterile cultures. Twelve(60%) of our patients underwent interval mastoidectomy, of which seven patients underwent mastoidectomy at two weeks, and ve patients were intervened at six weeks and rest eight were managed in the same sitting. No change was observed in these groups in terms of outcome after six weeks of follow-up. Although rare brain abscess continues to be a serious complication of otitis media which needs immediate attention with a multidisciplinary approach. Keywords: Brain abscess; Otogenic infection; Otitis media; Magnetic resonance imaging; Computed tomography

Clinical outcomes of different treatments and risk factors in patients with otogenic brain abscess, a real-world evidence-based retrospective study

Background Otogenic Brain Abscess (OBA) is a life-threatening complication secondary to otitis media, but its appropriate management remains controversial. Objectives To understand the demographic characteristics, management, and variables that affect the outcomes of patients with OBA based on our experiences over 11 years. Material and methods Clinical data were collected for 41 patients. Prognostic factors associated with mortality were assessed, and clinical outcomes compared among groups receiving different treatments. Results Among the 41 patients, 19.6% did not undergo surgery, 39.0% were treated with two-stage surgery (otological surgery and neurosurgery) and 41.4% were treated with single-stage surgery (otological surgery or neurosurgery). Overall mortality rate was 32.5%, and mortality was significantly higher in patients with invasion of the petrous apex (odds ratio [OR]: 7.81, 95% confidence interval [95% CI]: 1.26–48.36), and lower in those with appropriate surgical management (single otological surgery, OR: 0.07, 95% CI: 0–0.97; single neurosurgery, OR: 0.13, 95% CI: 0.02–1.0; two-stage surgery, OR: 0.08, 95% CI: 0.01–0.64) or a higher Glasgow Coma Scale (GCS) score at admission (OR: 0.64, 95% CI: 0.44–0.93). Conclusions and significance Data on invasiveness and pre-surgery GCS greatly aid in predicting the prognosis of OBA patients. Early evaluation will facilitate decision-making by physicians treating OBA patients.

Successful treatment with ultrasound-guided aspiration of otogenic brain abscess with transmastoid approach.

Successful treatment with ultrasound-guided aspiration of otogenic brain abscess with transmastoid approach.

Intracranial abscess formation in an adult alpaca: a case report

BackgroundIntracranial abscess formation is an extremely rare and sporadically documented disease in South American Camelids (SACs). Herein we report the first case of otogenic brain abscess formation in this species.Case presentationA 4 years old female alpaca was presented to our veterinary hospital with a 6 month history of neurologic disorder symptoms, mainly head tilt to the right and emaciation. A comprehensive workup (ultrasound and computed tomography) revealed irreversible cranial nerve abnormalities, extensive lesions in the region of external, middle and internal right ear including destruction of bony structures (tympanic bulla, parts of temporal bone) and severe brain deformation caused by an intracranial abscess. The lesion was up to 6x7x4 cm and occupying almost 40% of the cranial cavity. No pathological findings were evident in other organs or structures. The late referral of the alpaca at this advanced stage of destructive disease precluded surgical intervention.ConclusionsThis case report describes the clinical signs, diagnostic procedures and pathological findings in an adult female alpaca suffering from cranial nerve abnormalities caused by a massive otogenic brain abscess. Camelids suffering from otitis may not present with clinical signs until the pathology is severe. The importance of considering intracranial abscess formation as differential diagnosis in SACs showing the merest hint of nerve deficits cannot be emphasized enough in order to diagnose such pathological processes at an early and treatable stage.

Brain abscess in pediatric age: a review.

The purpose of the paper is to examine the current state of the art about epidemiology, diagnosis, and treatment of this infection. A review of the literature was performed through a PubMed search of original articles, case reports, and reviews using the key words "brain abscess," "cerebral abscess," "brain infection," "intracranial suppuration," "otogenic brain abscess," "otitis complications," and "sinusitis complications." Pediatric brain abscess is a rare but serious infection, often involving patients with specific risk factors and burdened by a high risk of morbidity and mortality. Brain abscess incidence and mortality decreased over the years, thanks to improved antibiotic therapy, new neurosurgical techniques, and the wide spread of vaccinations. There are no guidelines for the adequate diagnostic-therapeutic pathway in the management of brain abscesses; therefore, conflicting data emerge from the literature. In the future, multicentric prospective studies should be performed in order to obtain stronger evidences about brain abscesses management. Over the next few years, changes in epidemiology could be observed because of risk factors changes.