[Endocranial bacterial infections originating in the otorhinolaryngologic area]

The study reviewed 60 patients with various endocranial infections complicated by previous ORL infections. The mean age of patients was 41 years. Significantly more patients were males (70%). The majority of patients (55%) had previous chronic otitis media, 25% had tonsillopharyngitis and 20% had sinusitis. The majority of patients (68%) presented with meningitis. In addition to meningitis, 13% of the affected patients manifested signs of cerebritis. Cerebritis was found in 13% of patients. Three simultaneous complications were seen in two patients: meningitis, cerebritis and subdural empyema. Brain abscess developed two patients during the treatment. Aetiologic diagnosis of neuroinfections was made in 25% of cases. The most common cause was S. pneumoniae (66%), followed by E. coli, S. aureus, S. alpha haemolyticus and Acinetobacter spp. In two patients the same microorganisms were obtained by culture of cerebrospinal fluid and purulent content from the ear (S. pneumoniae and Acinetobacter spp.). Among patients with meningitis brain CT findings were mostly within normal limits, and mild diffuse oedema was found in patients with meningoencephalitis, while the patients with focal inflammatory brain diseases (cerebritis, abscessus and empyema) had solitary changes located mostly at the side of chronic otitis and near inflamming sinusitis. Following the treatment in our institution, 20% of patients underwent surgical treatment of chronical otitis or endocranial complications (empyema and abscessus). The mortality rate of patients was 35%.