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Related Experiment Videos

Gas-containing otogenic brain abscess.

Sergio Paolini1, Giovanni Ralli, Pasquale Ciappetta

  • 1Department of Neurosciences, Neurosurgical Service, S. Maria Hospital, Terni, Italy.

Surgical Neurology
|December 14, 2002
PubMed
Summary
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Gas-containing brain abscesses are rare, but this case highlights a potential origin from chronic otitis media. The study found that bacterial fermentation, not a direct connection to the outside, can cause gas within the abscess.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Gas-containing brain abscesses are exceptionally rare, with potential causes including bacterial fermentation or abnormal cranial communications.
  • Identifying the source of intracavitary gas often necessitates surgical exploration.

Observation:

  • A 54-year-old male presented with rapid neurologic decline and coma.
  • Computed tomography (CT) revealed a gas-filled cystic mass in the right temporal lobe.
  • Surgical intervention identified an abscess and an undiagnosed attic cholesteatoma from chronic otitis media.

Findings:

  • The brain abscess contained gas, attributed to fermentation by nonclostridial bacteria.
  • No direct communication between the abscess and the exterior was found.

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  • The patient recovered fully after surgical excision, mastoidectomy, and antibiotic treatment.

    • Implications:

    • This case suggests that otogenic brain abscesses can harbor gas due to bacterial fermentation.
    • It underscores the importance of considering chronic otitis media in the differential diagnosis of gas-containing brain abscesses.
    • Non-surgical etiologies for intracavitary gas in brain abscesses should be considered.