[Unusually high frequency of complications in acute otitis media]

Intracranial complications (ICC) secondary to otitis media are unusual but potentially life-threatening. We report an unusually high frequency of these events, and describe their clinical and epidemiological features.

A retrospective study of all pediatric patients with ICC admitted to our tertiary hospital from April 2004 to November 2007.

Eight patients had ICC: Sigmoid sinus thrombosis (4), lateral sinus thrombosis (1), meningitis (2), epidural abscess (1), otitic hydrocephalus (1). Four of the patients had acute mastoiditis. Pre-admission oral antibiotics were administered in 87.5% of the patients. Fever, otalgia, headache and VI and VII cranial nerves paralysis were the most frequent symptoms associated. The microorganism could be isolated in 3 patients: S pyogenes (2) and P mirabilis (1); the remaining patients had negative cultures. All of the patients received broad-spectrum parenteral antibiotics and 2 of them underwent a radical mastoidectomy.

We report an unusually high incidence of cranial complications secondary to acute otitis media. Multicenter studies are needed in order to assess whether there is an increase in the incidence of these events.