Abstract

Otogenic brain abscess (OBA) is a rare but serious complication of otitis media, particularly when associated with mastoiditis. We report a case of an otogenic brain abscess of a 56-year-old female who was transferred to our medical institution with clinical symptoms of otorrhea, otalgia and headache. Pre-operative CT and MRI Scan revealed right-sided suppurative otitis media, right-sided subdural abscess, mastoiditis and pansinusitis. Laboratory results showed CRP over 300mg/L before antibiotic therapy. Septicemia protocol was initiated upon admission, and Oto-rhino-laryngological and Neurosurgical consultations were requested. Emergent right-sided mastoidectomy including intracerebral abscess punction was performed whereby pus from the right temporal part of the brain was drained out. A few days later, due to the deterioration of the patient’s condition, a right-sided intracerebral abscess resection was performed. A histopathological examination later confirmed an abscess cavity/wall. The current follow-up examination revealed no recurrent/residual intracerebral abscess. This review aims to summarize the current understanding of the management of otogenic brain abscesses. The diagnosis of otogenic brain abscess (OBA) requires a high index of suspicion, thorough clinical evaluation, and neuroimaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI). Prompt and accurate diagnosis is crucial for timely intervention and improved outcomes. Multidisciplinary consultation/team (MDT) is essential to the success of OBA diagnosis and management. Despite advancements in diagnostics and therapeutics, otogenic brain abscesses remain associated with significant morbidity and mortality. Therefore, early recognition, aggressive treatment, and close monitoring are essential for optimizing patient outcomes.