[Cerebral and extrancerebral complications combined with otogenic meningitis with various outcomes].

OBJECTIVE

To increase the effectiveness of treatment of patients with otogenic meningitis based on the analysis of the frequency and structure of cerebral complications (CC) and extracerebral complications (ECC) with different outcomes.

MATERIAL AND

METHODS

The analysis of variants of the clinical course of otogenic purulent meningitis OPM in 51 patients with the isolation of combined CC and ECC, the immediate causes of death, was carried out.

RESULTS

OPM in 66.7±6.6% of cases was accompanied by combined central nervous system diseases, which in descending order included encephalitis, epidural empyema, thrombophlebitis of the cerebral sinuses and intracerebral abscess. In case of fatal outcomes of OPM, compared with favorable ones, the frequency of CC increased significantly in association with acute purulent otitis media (APOM) - from 50.0±10.7% to 92.9±8.5 (p≤0.02), to a lesser extent with exacerbation of chronic purulent otitis media (CPOM) - from 71.4±12.1% to 80.0±17.9. Sepsis was detected in all fatal cases, with favorable cases - in 54.5±10.6% in association with APOM and 21.4±11.0% with CPOM (p≤0.05). Infectious-toxic shock (40%), bilateral focal-drain pneumonia (33.3%) and cerebral edema (26.7%) were noted as the direct causes of death.

CONCLUSION

An analysis of the clinical course and thanatogenesis of OPM allows us to state that combined CC and ECC significantly increase the risk of fatal complications.