title: [Diagnosis and treatment of the complications of otitis media in adults. Case series and literature review].
abstract: BACKGROUND
  The complications of otitis media (intra-cranial and extra-cranial) used to have a high morbidity and mortality in the pre-antibiotic era, but these are now relatively rare, mainly due to the use of antibiotics and the use of ventilation tubes, reducing the incidence of such complications significantly. Currently, an early suspicion of these complications is a major challenge for diagnosis and management.
  
  
  METHODS
  The cases of 5 patients (all male) are presented, who were diagnosed with complicated otitis media, 80% (4) with a mean age of 34.6 years (17-52). There was major comorbidity in 60% (3), with one patient with diabetes mellitus type 2, and two with chronic renal failure. There were 3 (60%) intra-cranial complications: one patient with thrombosis of the sigmoid sinus and a cerebellar abscess; another with a retroauricular and brain abscess, and a third with meningitis. Of the 2 (40%) extra-cranial complications: one patient had a Bezold abscess, and the other with a soft tissue abscess and petrositis. All patients were managed with surgery and antibiotic therapy, with 100% survival (5), and with no neurological sequelae. The clinical course of otitis media is usually short, limiting the infection process in the majority of patients due to the immune response and sensitivity of the microbe to the antibiotic used. However, a small number of patients (1-5%) may develop complications.
  
  
  CONCLUSIONS
  Otitis media is a common disease in our country, complications are rare, but should be suspected when the picture is of torpid evolution with clinical worsening and manifestation of neurological signs.
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México.
authors.forename: Luis Humberto
authors.initials: LH
authors.lastname: Govea-Camacho
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México. Electronic address: dr_ramon_otorrino@yahoo.com.
authors.forename: Ramón
authors.initials: R
authors.lastname: Pérez-Ramírez
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México.
authors.forename: Arnulfo
authors.initials: A
authors.lastname: Cornejo-Suárez
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México.
authors.forename: Roberto
authors.initials: R
authors.lastname: Fierro-Rizo
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México.
authors.forename: Claudia Janet
authors.initials: CJ
authors.lastname: Jiménez-Sala
authors.affiliation: Otorrinolaringología y Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Médico del Seguro Social (IMSS), Guadalajara, México.
authors.forename: Carlos Silvino
authors.initials: CS
authors.lastname: Rosales-Orozco
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D019299:Decompression, Surgical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004322:Drainage; D004359:Drug Therapy, Combination; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D020227:Lateral Sinus Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008297:Male; D008417:Mastoiditis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008581:Meningitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D059270:Petrositis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Absceso cerebral; Abscess brain; Otitis media; Trombosis venosa; Venous thrombosis