Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to 5.6×3.4 cm with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.
Abscess ; Adolescent ; Brain ; Cefotaxime ; Child ; Drainage ; Ear ; Eikenella corrodens ; Eikenella ; Empyema ; Epidural Abscess ; Fever ; Follow-Up Studies ; Head ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Mastoid ; Mastoiditis ; Neck ; Otitis Media ; Physical Examination ; Sinusitis ; Sphenoid Sinus ; Sphenoid Sinusitis ; Suppuration ; Temporal Lobe ; Trephining ; Vancomycin ; Vomiting

Zygomatic mastoiditis is an extremely rare cause of an inflamed, swollen cheek. We encountered a 10-year-old girl with left preauricular swelling, pain, and mild trismus. Temporal bone computed tomography revealed a zygomatic root abscess with bone defects and a scanty amount of soft tissue lesion in Prussak's space. After antibiotic therapy for 2 weeks, her pain subsided, but the swelling persisted. All inflamed air cells, including the lesion in the zygomatic root, were eradicated. The swelling subsided after the surgery. The patient has not experienced any postoperative complications or shown any evidence of relapse for more than 1 year.
Abscess ; Cheek ; Child ; Female ; Humans ; Mastoid ; Mastoiditis ; Postoperative Complications ; Recurrence ; Temporal Bone ; Trismus ; Zygoma

Child, Preschool ; Humans ; Magnetic Resonance Imaging ; Male ; Mastoiditis ; complications ; Sinus Thrombosis, Intracranial ; etiology

This young adult man presented to ENT clinic with a complaint of left facial weakness and persistent left retro-auricular pain. High resolution CT of the mastoids was performed following clinical assessment. In this case, there is extensive sclerotic bony expansion with a ground-glass appearance involving the left zygoma, sphenoid and petrous temporal bone. The bony expansion is centred on the medullary bone and has an abrupt zonal transition (Figure 1). The bone involvement encompasses almost complete bony stenosis of the left external auditory meatus down to 1-2mm with consequential fluid in the external auditory canal and middle ears (Figure 2). The bony expansion involves both the tympanic and mastoid segments of the facial canal which are stenosed. The ossicular chain remains intact. The left mastoid air cells are under-pneumatised and completely occupied by fluid.
Human ; Male ; Young Adult ; Facial Paralysis ; Mastoiditis ; Tomography Scanners, X-Ray Computed

OBJECTIVE: To study the clinical feature and treatment of extracranial and intracranial complications caused by otitis media. METHOD: Three hundred and twenty patients of acute and chronic otitis media were admitted to our department between 2005 and 2014. Among them, 34 patients were diagnosed with extracranial and intracranial complications. The clinical features and treatment outcome were retrospectively studied. Of the 34 patients associated with complications, 25 had a single complication,8 had two complications and 1 had three complications. Complications included labyrinthitis in 14 cases, facial paralysis in 11, postauricular subperiosteal abscess in 6, Bezold abscess in 1, thrombophlebitis of sigmoid sinus in 2, otitis meningitis in land otogenic brain abscess in 8. RESULT: Thirty-three patients were cured or improved and 1 patient died. CONCLUSION Due to the widespread use of antibiotics, the clinical manifestations of extracranial and intracranial complications of otitis media become more hidden and atypical. The surgery is the primary treatment method.
Brain Abscess ; complications ; Chronic Disease ; Facial Paralysis ; complications ; Humans ; Labyrinth Diseases ; complications ; Mastoiditis ; complications ; Meningitis ; complications ; Otitis Media ; complications ; physiopathology ; Retrospective Studies ; Treatment Outcome

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

OBJECTIVE: To analyze the clinical features and treatment of tuberculous otitis media and mastoiditis. METHOD: Thirteen patients with tuberculous otitis media and mastoiditis were retrospectively analyzed and the related literatures were reviewed. One case was treated by surgery only, and anti-tuberculosis treatment was given to another one patient, and surgical removal of disease lesions in combination with anti-tuberculosis treatment were given to 12 patients. RESULT: One patient received surgery only was found to recur after follow-up for seven months. The patient did not recur after seven months' follow-up after antituberculosis therapy,and other patients did not recur. CONCLUSION Although the regular anti-tuberculosis chemotherapy treatment was the main treatment for tuberculous otitis and mastoiditis, surgical treatment was helpful to achieved more rapid healing of the ear.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Mastoiditis ; microbiology ; Middle Aged ; Mycobacterium tuberculosis ; Otitis Media ; microbiology ; Retrospective Studies ; Tuberculosis ; Young Adult

PURPOSE: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. METHODS: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. RESULTS: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time* frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis? in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). CONCLUSION: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.
Academic Medical Centers ; Carbon Monoxide ; Earache ; Electronic Mail ; Emergencies* ; Humans ; Hyperbaric Oxygenation* ; Critical Care ; Mastoid ; Mastoiditis ; Medical Records ; Oxygen ; Retrospective Studies ; Skin Care ; Wounds and Injuries

The incidence of mastoiditis in pediatric age has consistently increased over the last two decades due to increase of antibiotic-resistant bacteria. Compared to young patients, occurrence of acute otitis media complications such as acute mastoiditis and subperiosteal abscess is relatively low in adults. Various treatments for acute mastoiditis with subperiosteal abscess such as tympanostomy tube insertion, intravenous antibiotics, and postauricular incision and drainage have avoided the morbidity and necessity of mastoid surgery. Recently, many studies have indicated mastoidectomy only in cases of severe complications or failure of disease improvement after antibiotic treatment and myringotomy. In this report, we present two cases of successful treatment of subperiosteal abscess and discuss the management of acute mastoiditis with subperiosteal abscess in both child and adult.
Abscess ; Adult ; Anti-Bacterial Agents ; Bacteria ; Child ; Drainage ; Humans ; Incidence ; Mastoid ; Mastoiditis ; Middle Ear Ventilation ; Otitis Media

Epidural abscess is the most common intracranial complication of acute mastoiditis and may lead to a life-threatening condition if an appropriate treatment is not performed. The treatment of choice is a surgical eradication of lesion, drainage of the abscess, and intravenous antibiotic therapy. We report a case of acute mastoiditis followed by an epidural abscess in the posterior cranial fossa in a 32-month male patient.
Abscess ; Cranial Fossa, Posterior ; Drainage ; Epidural Abscess ; Humans ; Male ; Mastoid ; Mastoiditis ; Otitis Media