Objective: To aid clinicians in the early identification of life-threatening otogenic intracranial abscesses(OIA) through recognition of signs and symptoms.
Setting: Tertiary referral centre in Melbourne, Australia.
Subjects and Methods: 5 patients, aged 6-31, with otogenic intracranial abscesses, were identified with ICD-10 diagnostic codes. Charts were reviewed for history, examination, investigations, treatment and outcomes.
Results: Headache was the most common presenting symptom (5 of 5 patients), followed by fever (present in 4 of 5 patients), seizures (3 of 5 patients) and confusion (3 of 5 patients). Nausea with vomiting was seen in 2 patients, so was ear discharge. One patient developed complete left-sided facial nerve palsy with disdiadochokinesia and vertigo.
Conclusion: An OIA is a life-threatening condition requiring aggressive surgical and antibiotic therapy. Acute or chronic otitis media can lead to OIA, and the diagnosis should be considered in all such patients presenting with a headache, fever, seizures and confusion, especially after failing conservative treatment.