Suppurative intracranial complications of upper respiratory tract infections.

Suppurative intracranial complications of respiratory infections are relatively rare in children. These complications occur more often in association with chronic sinusitis and chronic otitis media. Because symptoms and signs of the intracranial complications can be nonspecific, a high index of suspicion by the physician is important for early diagnosis. The routine cerebrospinal fluid examination often does not distinguish between the various complications, and radiologic procedures such as radionuclide brain scan, arteriography and computer-assisted tomographic scan should be used. Computer-assisted tomographic scan is very useful in detecting early complications allowing trial with medical treatment alone. Appropriate selection of antibiotics must be made on the basis of the likely pathogens in the particular setting and the ability of the antibiotic to penetrate the affected area. Appropriate early management of suppurative intracranial complications should result in a favorable outcome.