Central nervous system complications secondary to oto-rhinologic infections. An analysis of 39 pediatric cases.
Fifty-eight central nervous system complications were noted in 39 pediatric patients with a primary oto-rhinological infection. The ages ranged from 1 to 15 years. Eleven patients (25%) had more than one complication. 12.8% of the cases died. Leptomeningitis was the most common intracranial complication (54%) Lateral sinus thrombosis (LST) occurring in 10 patients (26%) was accompanied with other intracranial abnormalities in 80% of cases. Brain abscess as an initial or concomitant complication was associated with the highest mortality rates (40%). In two of these fatal cases multiple brain abscesses were detected. The low incidence of intracranial infections secondary to oto-rhinologic infections and the masking effect of antibiotics present difficulties in the early recognition of the CNS complication. Despite the value of the modern imaging techniques in the investigation of the CNS complication, the clinical oto-rhinologic examination is of paramount importance in detecting the original infection in the pneumatic spaces of the upper respiratory tract. Additionally, bone scans were found of value in demonstrating the osteitic process of these cases.
Kraus
M
M
Department of Otolaryngology, Soroka University Hospital, Beer-Sheva, Israel.
Tovi
F
F
D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging; D002493:Central Nervous System Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007239:Infections / Q000150:complications*; D008297:Male; D010033:Otitis Media / Q000150:complications*; D011859:Radiography; D012852:Sinusitis / Q000150:complications*