Open AccessOtogenic brain abscesses: A systematic review
Author(s) -
Duarte Maria J.,
Kozin Elliott D.,
Barshak Miriam B.,
Reinshagen Katherine,
Knoll Renata M.,
Abdullah Kalil G.,
Welling D. Bradley,
Jung David H.
Publication year - 2018
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.150
Subject(s) - medicine , brain abscess , otitis , vomiting , nausea , systematic review , chronic suppurative otitis media , complication , surgery , intensive care medicine , pediatrics , abscess , medline , political science , law
Objective Otogenic brain abscesses are one of the most significant life‐threatening complications of otologic infections. Given their low prevalence, otogenic brain abscesses require a high index of suspicion for diagnosis. In this systematic review, we aim to provide an analysis of otogenic brain abscesses and describe common clinical signs and symptoms, bacteriology, location, treatment options, morbidity, and mortality. Data Sources PubMed, Cochrane CENTRAL database, Google Scholar, and Scopus. Methods A systematic review of literature was performed using the Preferred Reporting Items for Systematic Reviews and Meta‐analyses recommendations. Variables assessed included clinical signs and symptoms, bacteriology, location, treatment, morbidity, and mortality. Results Twenty‐nine studies met inclusion and exclusion criteria, corresponding to a total of 1307 otogenic abscess cases for review. Fifty‐five percent of abscesses were found in the temporal lobe and 28% in the cerebellum. Most patients (88.3%) had a history of suppurative chronic otitis media. The most common symptoms were headache, altered mental status, papilledema, and meningeal irritation. Fever, nausea, and vomiting affected about 40% of patients. The most commonly cultured bacterial species was Proteus mirabilis . In addition to antibiotics, most otogenic brain abscesses were treated by burr hole aspiration. Average mortality following advent of computed tomography was 8.11%. Conclusion Although rare, otogenic brain abscesses may occur as a complication of suppurative otitis media and require a high index of suspicion. Appropriate imaging studies and multidisciplinary expertise are crucial in the diagnosis and management. Level of Evidence 4.