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Case report: Otitis media with subsequent mastoiditis and cerebral herniation in a patient with Arnold chiari

Oskar Feussner1, Roland Haase1, Jan Baier1

  • 1Department for Operative and Nonoperative Pediatrics and Adolescent Medicine, Section for Neonatology and Pediatric Critical Care, University Hospital, Halle, Germany.

Frontiers in Pediatrics
|February 9, 2023
PubMed

Insights

A rare, fatal complication of otitis media occurred in a 13-year-old boy with Arnold-Chiari Malformation. Streptococcus intermedius infection led to brainstem compression and brain death, highlighting the need for vigilance.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Otitis media is a common childhood infection.
  • Arnold-Chiari Malformation is a structural defect in the cerebellum.

Observation:

  • A 13-year-old boy presented with sudden collapse after presumed otitis media.
  • Imaging revealed mastoiditis, a cerebellopontine angle mass, and Arnold-Chiari Malformation.

Findings:

  • Cerebrospinal fluid (CSF) analysis and mastoid biopsy indicated an inflammatory etiology.
  • Blood and CSF cultures identified Streptococcus intermedius.
  • The mass compressed the brainstem, leading to brain death.

Implications:

  • This case highlights a rare, lethal complication of acute otitis media in a patient with a cerebral malformation.
  • It underscores the importance of continued vigilance for persistent symptoms post-otitis media treatment.
  • Early recognition and intervention are critical in managing complex pediatric neurological emergencies.

Keywords:
arnold-chiari-malformationbrain abscesmastoiditisotitis mediasudden death

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