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Published on: February 29, 2020
[Acute mastoiditis with intracranial complication in a pediatric patient]
Sara Laliena Aznar1, Cayetana Verástegui Martínez2, Raquel Bernadó Fonz3
1Servicio de Pediatría, Hospital Infantil Miguel Servet, Zaragoza, España. saralaliena@gmail.com.
Abstract:
Acute mastoiditis is an infection that affects the mastoid air-cell system, usually due to the progression of an acute otitis media. The bacteria most frequently isolated in acute mastoiditis are Streptococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus. The mastoid infection can extend affecting contiguous structures and producing intra or extracranial complications. The most frequent ones are intracranial complications, including meningitis, temporal lobe or cerebellar abscess, epidural or subdural abscess and venous sinus thrombosis. We present the case of a 4-year-old girl who developed two intracranial complications (intracranial epidural abscess and transverse and sigmoid sinus thrombosis) initiated in an acute mastoiditis produced by Streptococcus pyogenes.
Insights
Acute mastoiditis, a middle ear infection, can lead to severe intracranial complications. This case highlights Streptococcus pyogenes causing epidural abscess and sinus thrombosis in a child.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Neurosurgery
Background:
- Acute mastoiditis is a bacterial infection of the mastoid air-cell system, often stemming from acute otitis media.
- Common causative agents include Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus.
- Mastoid infections can spread to adjacent structures, leading to serious intra or extracranial complications.
Observation:
- A 4-year-old girl presented with acute mastoiditis.
- The infection was caused by Streptococcus pyogenes.
- She developed two significant intracranial complications: an intracranial epidural abscess and transverse and sigmoid sinus thrombosis.
Findings:
- Streptococcus pyogenes can cause severe intracranial complications originating from acute mastoiditis.
- The case demonstrates the potential for rapid progression from mastoid infection to life-threatening conditions.
- Co-occurrence of epidural abscess and venous sinus thrombosis is a critical finding.
Implications:
- Early recognition and aggressive treatment of acute mastoiditis are crucial in pediatric patients.
- Prompt management of intracranial complications is essential to prevent neurological damage or mortality.
- This case underscores the importance of considering rare but severe complications in mastoiditis management.
