engleski

Otogenic multiple brain abscesses - a review of four cases.

Infections of the middle ear are in general the most common predisposing condition leading to bacterial seeding of the intracranial space. This may occur by either drainage of purulent material via valveless emissary veins of direct extension from a contiguous cranial site of infection. We present four consecutive patients with multiple brain abscesses presenting in period of 10 years in three different hospitals. All of them were otogenic and followed by fever, meningismus and focal neurologic signs. One of the patient was in coma. Beside common otoscopic and radiologic examination in all patients a CT scan was performed. Abscesses were located in temporal lobe, cerebellum or in both localization at the same time. The most common microorganism involved was Proteus. Each patient reacted well on combination of antibiotic and steroid treatment. Conservative therapy was followed by mastoidectomy and anticoantrotomy. Only in one case intracranial assessment of therapy was needed. Multiple brain abscesses is severe otogenic complication. Mortality is higher than in single abscesses, varying between 14-31%. It represents a potentially curable condition ; provided by appropriate antibiotic treatment. Elimination of the primary focus of infection was the most important step in management of this condition.

Brain abscess; review

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