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[Intracranial complications of otorhinologic infections]
Insights
Central nervous system (CNS) complications from otorhinological infections are common, especially in children. Early diagnosis and treatment are crucial due to significant mortality, particularly from brain abscesses.
Area of Science:
- Otolaryngology
- Neurology
- Infectious Diseases
Background:
- Otorhinological infections frequently lead to central nervous system (CNS) complications.
- These complications pose a significant risk, particularly in pediatric patients.
Purpose of the Study:
- To analyze the incidence, types, and outcomes of CNS complications secondary to otorhinological infections.
- To highlight the mortality rates and common complications associated with these infections.
Main Methods:
- Retrospective analysis of 70 patients with initial otorhinological infections and subsequent CNS complications.
- Review of patient demographics, complication types, treatments, and outcomes.
Main Results:
- 87 CNS complications were identified in 70 patients; 57% were children.
- Leptomeningitis (43%) was most common in pediatric patients. Brain abscesses had the highest mortality (38%).
- Despite antibiotic use, mortality remains high (14%), with 21% experiencing multiple complications.
Conclusions:
- CNS complications from otorhinological infections remain a serious concern with substantial mortality.
- Early and thorough otorhinological examination is vital for identifying extracranial infection sources.
- Advanced imaging aids localization, but a comprehensive clinical assessment is essential for effective management.
Abstract:
In 70 patients with initial otorhinological infections there were 87 different central nervous system (CNS) complications. 40 (57%) were children (from 1 month to 15 years). 15 (21%) had more than 1 complication. Mortality was 14% (10/70). Leptomeningitis was the most common CNS complication (43%) and it occurred mainly in the pediatric age group. Lateral sinus thrombosis (LST) was accompanied by other intracranial infections in 80% of the patients. The highest mortality was found in patients with brain abscess (38%) as the initial or concomitant complication. Despite liberal use of antibiotics, CNS complications of otorhinologic infections are still encountered with considerable mortality rates. Modern imaging techniques are of great value in localizing the intracranial disease, but a complete initial otorhinologic examination is needed to rule out an extracranial focus of infection, sometimes with an insidious course.