A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae

Jee-Hyun Choi; Min-Sung Kim; Jong-Hyun Kim; Byung-Chul Son; Seong Joon Kim; So Hyun Park; Jung Hyun Lee; Jin Hee Oh; Dae Kyun Koh

doi:10.14776/kjpid.2014.21.2.144

Journal List > Korean J Pediatr Infect Dis > v.21(2) > 1096425

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Choi, Kim, Kim, Son, Kim, Park, Lee, Oh, and Koh: A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae

Case Report

Korean J Pediatr Infect Dis 2014;21(2):144-149.

Published online: 20 January 2014

DOI: https://doi.org/10.14776/kjpid.2014.21.2.144

A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae

Jee-Hyun Choi, M.D., Min-Sung Kim, M.D., Jong-Hyun Kim, M.D., Byung-Chul Son, M.D.^∗, Seong Joon Kim, M.D., So Hyun Park, M.D., Jung Hyun Lee, M.D., Jin Hee Oh, M.D., Dae Kyun Koh, M.D.

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea

^∗Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea

Received 21 October 2013 Revised 6 December 2013 Accepted 15 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acute mastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.

Keywords: Epidural abscess, Mastoiditis, Otitis media, Streptococcus pneumoniae

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Fig. 1.

Computed tomography of temporal bone revealed both otoma-stoiditis (circle) (A) and abscess formation in the overlying soft tissue in left mastoid region (arrow) (B). There was a suspicious lesion of intracranial abscess formation in the left posterior cranial fossa (B).

Fig. 2.

Magnetic resonance imaging scan of brain revealed both otoma-stoiditis (circle), an extracranial abscess in the left mastoid region (right arrow) (A) and intracranial abscess in left posterior cranial fossa (left arrow) with meningitis and thrombophlebitis (right arrow) (B).

Fig. 3.

On otoscopy after postoperative weeks 8, ear drums were normal (A, B), and magnetic resonance imaging scan showed no evidence of abscess (C).

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