Korean J Pediatr Infect Dis.  2014 Aug;21(2):144-149.

A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae

• Choi JH
• Kim MS
• Kim JH
• Son BC
• Kim SJ
• Park SH
• Lee JH
• Oh JH
• Koh DK

Abstract

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.

Keyword

Epidural abscess; Mastoiditis; Otitis media; Streptococcus pneumoniae

MeSH Terms

Anti-Bacterial Agents
Child
Communicable Diseases
Drainage
Epidural Abscess*
Fever
Humans
Lateral Sinus Thrombosis
Masks
Mastoid*
Mastoiditis*
Otitis Media
Streptococcus pneumoniae*
Anti-Bacterial Agents

Figure

• 

  Fig. 1. Computed tomography of temporal bone revealed both otoma-stoiditis (circle) (A) and abscess formation in the overlying soft tissue in left mastoid region (arrow) (B). There was a suspicious lesion of intracranial abscess formation in the left posterior cranial fossa (B).

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  Fig. 2. Magnetic resonance imaging scan of brain revealed both otoma-stoiditis (circle), an extracranial abscess in the left mastoid region (right arrow) (A) and intracranial abscess in left posterior cranial fossa (left arrow) with meningitis and thrombophlebitis (right arrow) (B).

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  Fig. 3. On otoscopy after postoperative weeks 8, ear drums were normal (A, B), and magnetic resonance imaging scan showed no evidence of abscess (C).

Reference

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