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Diagnostic challenges in otogenic brain abscesses
Tina Kissow Lildal1, Jakob Korsholm, Therese Ovesen
1Øre-næse-hals-afdelingen, Aarhus Universitetshospital, Nørrebrogade 44, 8000 Aarhus C, Denmark. kissow@hotmail.com.
Danish Medical Journal
|June 21, 2014
Summary
Otogenic brain abscess (OBA) is rare but serious. This study found OBA incidence at 1/million, with varied symptoms mimicking meningitis or stroke, emphasizing prompt ENT evaluation for early diagnosis and treatment.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Otogenic brain abscess (OBA) is a rare but severe complication of otitis media.
- Early diagnosis and treatment are critical for successful outcomes in OBA cases.
Purpose of the Study:
- To determine the incidence of OBA in a Danish population.
- To describe the clinical presentation, management strategies, and patient outcomes for OBA.
Main Methods:
- Retrospective review of 93 patients diagnosed with brain abscess between 1999 and 2010.
- Data collection included patient demographics, symptoms, clinical findings, comorbidities, imaging, microbiology, and treatment details.
Main Results:
- Seven cases of OBA were identified, with an incidence of 1 per million population.
- Patient age ranged from 10 to 81 years; symptoms varied, mimicking meningitis in younger patients and stroke in older patients.
- No mortalities were recorded, but three patients experienced sequelae including hearing loss and/or neurological impairment.
Conclusions:
- OBA presentation can mimic meningitis or stroke, and fever may be absent.
- Prompt ear, nose, and throat (ENT) examination is essential for identifying the source of infection and guiding treatment, even without apparent ear symptoms.
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