Fatal Intracranial Complications of Otitis Media - A case report

Introduction: Chronic otitis media is a relatively common disease. Nowadays it commonly believe that potentially fatal intracranial complications are rare with the advent of antibiotics and better healthcare. In this case report, we present a young gentleman who had undiagnosed chronic otitis media complicated with fatal intracranial complications. Case Report: A 23 years old gentleman presented with 6 days history of fever with right sided otalgia and facial paralysis.On the day of admission he also developed weakness of the left lower limb. Further history revealed that he had recurrent episode of otorhoea and otalgia for many years without prior consultation with otolaryngologist. Examination revealed spike of temperature with right sided facial nerve palsy House Brickman grade V and effusion with retracted tympanic membrane on the right ear with granulation tissue. Neurological examination showed reduce power on the left lower limb. His white cell count raised to 30 and increased C reactive protein (CRP) to 125. Contrast Enhanced Computed Tomography (CECT) was done, showing subdural empyema with associated mass effect,midline shift, generalized edema, right uncal herniation, complicated with dural venous sinus thrombosis and mastoiditis. He was started on intravenous ceftriaxone and underwent examination under microscope, craniotomy and evacuation of subdural empyema. Pus culture and sensitivity (C&S) grew bacteroides stercoris. Repeated CT scan post-operative showed unchanged subdural collection at right paramedian and right tentorium cerebelli regions with associated generalized edema, mass effect and suspicious uncal herniation. His condition deteriorated and later underwent decompressive craniectomy. Unfortunately his clinical conditions continue to deteriorate further till he finally succumbed to his illness. Conclusion: Chronic otitis media relatively Disclaimer: Abstract text might vary slightly from what is displayed in the e-poster.This poster was submitted to the 14th National Conference for Clinical Research (NCCR) in August 18-20, 2021. https://nccrconference.com.my