Ignoring ear rot disease spreading to brain abscess

Mr. Nghiem Xuan H. (68 years old, Nghia Dan, Nghe An) was hospitalized due to otitis externa, complicated by brain abscess. Before that, Mr. H. had an ear infection but was not treated completely. Mr. H and his relatives thought that it was just a common “ear rot” expression, sprinkled with medicine and that was it.

Until an ear infection accompanied by a severe headache, Mr. H. went to the hospital for examination. The doctor examined the patient’s ear and discovered that the patient’s ear was draining pus, suspecting a brain abscess due to an ear infection. CT scan diagnoses brain abscess due to otitis media. The patient was quickly operated on.

According to Associate Professor Nguyen Thi Hoai An – Director of An Viet General Hospital, brain abscess due to ear infection is a rare disease but has a high mortality rate. for the patient. Therefore, actively seeking knowledge related to this disease is very necessary.

Associate Professor An ear endoscopy for patients with ear infections.

Ear infections can cause complications in the brain because the brain organization is very close to the ear, there are places where the meninges are only 1mm thick from the ear by the bone wall, even in some places only 0.5mm.

Infection from the lining of the ear, mastoid goes through the way of osteomyelitis, the bone is destroyed, passes through the blood vessels of the clefts to the dura mater, causing brain damage, including brain abscess.

According to PGS An, infections from the ear follow the blood route to the brain. Common dangerous complications caused by ear infections include: brain abscess, meningitis and phlebitis due to the ear.

In the early stages, the most common sign of a patient with a brain abscess due to an ear infection is a mild to severe headache, which lasts for a long time, does not decrease with medication. At this stage, patients often do not notice due to very few symptoms of the disease.

As brain abscess progresses, clinical manifestations focus on the following three major syndromes:

The syndrome of increased intracranial pressure with headache, which becomes increasingly severe, may be localized on one side or only in the occipital region. The patient occasionally hits his head with his hand.

Mentally slow, stagnant, babbling, not wanting to interact with others. The pulse is irregular, sometimes fast, sometimes slow. Papillary edema, can be unilateral or bilateral papilledema. The patient vomits, walks unsteadily due to dizziness.

Infectious syndrome has additional symptoms such as fever, rapid weight loss, high white blood cells in the presence of high fever.

Focal neurological syndrome: Usually occurs late due to cerebral abscess.

Hemiplegia on the opposite side, ophthalmoplegia, partial or total convulsions, aphasia.

For patients with cerebellar abscess: Unsteady, often falling, shaking hands when moving, overexertion, confusion, nausea, difficulty swallowing…

According to PGS An, if brain abscess is not diagnosed and treated promptly, the rate of patients dying from ear infections causing brain abscess is high. Therefore, when patients see any signs of ear infection, especially purulent ear infection, purulent ear infection, they should immediately go to a medical facility for timely diagnosis and treatment, to avoid dangerous complications. danger, such as a brain abscess.

To prevent the disease, Associate Professor An said that the important measure for patients is to clean the nose and throat, prevent upper respiratory tract infections to prevent purulent ear discharge.

If there is purulent ear discharge, it should be treated thoroughly to avoid a dangerous middle ear infection. With dangerous cases of otitis media, it is necessary to treat and operate early, especially when cholesteatoma is present.

Khanh Chi