Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris · 2005
[Intra cranial abscess and empyemas from E.N.T. origin].
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Page C, Lehmann P, Jeanjean P, Strunski V, Legars D
Аннотация
OBJECTIVES: The purpose of this study was to evaluate the diagnosis criteria, the bacteriology and the evolution after adapted treatment of intracranial abscess of ENT origin.
MATERIAL AND METHODS: It was a retrospective study from 1985 to 2003 concerning 22 patients who had brain abscesses secondary to an ENT infection.
RESULTS: The infectious origin was sinusoid in 32% of cases, otologic in 32% of cases, pharyngeal or dental in 27% of cases and cutaneous in 9% of cases. The clinical symptoms were: fever in 55% of cases, headache in 73% of cases (Intra cranial hypertension syndrome in 23% of cases), epilepsy in 32% of cases and various other neurologic symptoms. Bacteria were identified in 82% of cases. In 50% of cases multibacterial associations were found. All the patients had bi antibiotherapy associated to surgical excision of the abscess (16 cases) or single (or more) punction (stereotaxic guided or not) of the abscess. 3 patients (14%) died and 50% are alive and well.
CONCLUSION: The diagnosis of cerebral abscess is often difficult. The "classical" intracranial hypertension associated to high fever is usually incomplete and sometimes absent. There is no predominant bacteria involved and multibacterial infections are frequent. Despite abscesses are serious and potentially lethal, an early diagnosis, a medical (antibiotics) and surgical treatment (punction and/or surgical excision) may completely be cured in more than 50% of cases.
MATERIAL AND METHODS: It was a retrospective study from 1985 to 2003 concerning 22 patients who had brain abscesses secondary to an ENT infection.
RESULTS: The infectious origin was sinusoid in 32% of cases, otologic in 32% of cases, pharyngeal or dental in 27% of cases and cutaneous in 9% of cases. The clinical symptoms were: fever in 55% of cases, headache in 73% of cases (Intra cranial hypertension syndrome in 23% of cases), epilepsy in 32% of cases and various other neurologic symptoms. Bacteria were identified in 82% of cases. In 50% of cases multibacterial associations were found. All the patients had bi antibiotherapy associated to surgical excision of the abscess (16 cases) or single (or more) punction (stereotaxic guided or not) of the abscess. 3 patients (14%) died and 50% are alive and well.
CONCLUSION: The diagnosis of cerebral abscess is often difficult. The "classical" intracranial hypertension associated to high fever is usually incomplete and sometimes absent. There is no predominant bacteria involved and multibacterial infections are frequent. Despite abscesses are serious and potentially lethal, an early diagnosis, a medical (antibiotics) and surgical treatment (punction and/or surgical excision) may completely be cured in more than 50% of cases.