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Complications of Otitis Media: Mastoiditis and an Intracranial Abscess Presenting as Behavioral Changes
Tamer Yahya1, Emily C Barbee1, Ameer Kittaneh2
1Department of Emergency Medicine, Mercy Health - St. Rita's Medical Center, Lima, USA.
Abstract:
An intracranial abscess is a rare but life-threatening complication of otitis media (OM) and mastoiditis that requires rapid diagnosis and intervention. We present the case of a 43-year-old woman who presented with acute altered mental status and aggressive behavior following recent treatment for OM. Physical examination revealed a perforated, purulent right tympanic membrane, and neuroimaging confirmed bilateral mastoiditis and a right temporal lobe brain abscess with midline shift. Following treatment with broad-spectrum intravenous antibiotics, the patient underwent a successful craniotomy for abscess evacuation, a mastoidectomy, and tympanostomy tube placement. Postoperatively, her behavioral and neurological symptoms fully resolved, and she was discharged to complete a prolonged course of antimicrobial therapy. This case underscores the importance of maintaining a high index of suspicion for otogenic intracranial complications in patients presenting with acute behavioral changes, emphasizing that early, multidisciplinary surgical and medical management is essential to optimize patient outcomes.
Insights
A rare brain abscess complication of otitis media (OM) was successfully treated. Early diagnosis and multidisciplinary management of this otogenic intracranial complication are crucial for positive patient outcomes.
Area of Science:
- Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Intracranial abscesses are rare but life-threatening complications of otitis media (OM) and mastoiditis.
- Prompt diagnosis and intervention are critical for managing these severe infections.
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