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[Intra cranial abscess and empyemas from E.N.T. origin]
C Page1, P Lehmann, P Jeanjean
1Service d'ORL et de chirurgie cervico-faciale, C.H.U. Amiens, Hôpital Nord, place Victor Pauchet 80054 Amiens Cedex 1. Cyril.Page@caramail.com
Summary
Brain abscesses from ENT infections are challenging to diagnose. Early treatment combining antibiotics and surgery offers a greater than 50% cure rate for these serious intracranial infections.
Area of Science:
- Neurology
- Infectious Diseases
- Otolaryngology
Context:
- Intracranial abscesses originating from Ear, Nose, and Throat (ENT) infections present diagnostic and therapeutic challenges.
- This retrospective study analyzed 22 cases of brain abscesses secondary to ENT infections between 1985 and 2003.
Purpose:
- To evaluate diagnostic criteria for intracranial abscesses of ENT origin.
- To characterize the bacteriology of these abscesses.
- To assess patient outcomes following adapted treatment strategies.
Summary:
- Infectious origins included sinus (32%), otologic (32%), pharyngeal/dental (27%), and cutaneous (9%). Common symptoms were headache (73%) and fever (55%), with neurological deficits also noted.
- Bacteria were identified in 82% of cases, frequently as multibacterial infections (50%).
- Treatment involved combined antibiotic therapy and surgical intervention (excision or puncture).
Impact:
- Cerebral abscess diagnosis can be difficult, as classic symptoms like high fever and intracranial hypertension are often incomplete or absent.
- Multibacterial infections are common, and no single predominant bacterium was identified.
- Despite the serious nature of brain abscesses, early diagnosis and prompt, combined medical and surgical treatment result in a cure rate exceeding 50%.