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[A patient with confusion and pneumocephalus: what is your diagnosis?]

R Cavassini1, E Guyot, N Theumann

  • 1Centre interdisciplinaire des urgences, Département de médecine interne, CHUV, Lausanne.

Praxis
|January 14, 2005
PubMed

Insights

A rare case of adult mastoiditis caused a 58-year-old male

Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Adult mastoiditis is uncommon, often presenting without classic symptoms.
  • Meningoencephalitis and pneumocephalus can be complications of undiagnosed mastoiditis.

Observation:

  • A 58-year-old male presented with acute meningoencephalitis and pneumocephalus on CT scan.
  • Head CT suggested mastoiditis despite the absence of typical otologic signs.

Findings:

  • Mastoidectomy and antibiotics led to full recovery.
  • Streptococcus pneumoniae was identified in surgical samples.

Implications:

  • Highlights the need for high clinical suspicion for mastoiditis in adults with encephalitis of unknown origin.
  • Emphasizes the importance of advanced imaging in diagnosing subtle cases.

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