The Leaking Ear: A Billiard Ball Sized Otogenic Acute Brain Abscess
  • Thomas Matthews
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • Cathy Keegan
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • David McDonnell
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • Peter Loughman
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • Mohammad Amin Mirbalouchzehi
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • Kevin Veerasamy
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland
  • Niall Colwell
    Department of Medicine, Tipperary University Hospital, Clonmel, County Tipperary, Ireland

Keywords

Otogenic brain abscess, candidaemia

Abstract

An otogenic origin is identified in over half of cases pertaining to brain abscess.  They are typically associated with either mastoiditis, cholesteatoma or otitis media and carry a risk of mortality in the region of twenty per cent.  We describe the case of a 71-year-old gentleman presenting with acute confusion and unilateral neurology in the absence of systemic signs of sepsis or associated laboratory biomarkers who was diagnosed with a particularly large spherical temporal lobe brain abscess of 5cm diameter on neuroimaging.  This abscess was treated successfully with craniotomy, evacuation and a prolonged course of anti-microbials enabling him to return to his pre-morbid level of functioning.  His prolonged course of anti-microbials was complicated by a candidaemia and colonisation of an indwelling central venous catheter that was treated successfully with antifungals.

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    Published: 2023-04-06
    Issue: 2023: Vol 10 No 4 (view)

    How to cite:
    1.
    Matthews T, Keegan C, McDonnell D, Loughman P, Mirbalouchzehi MA, Veerasamy K, Colwell N. The Leaking Ear: A Billiard Ball Sized Otogenic Acute Brain Abscess. EJCRIM 2023;10 doi:10.12890/2023_003774.