Saving the life of a patient in critical condition due to otitis media and brain abscess complications

(Baonghean.vn)- After a period of prolonged ear infection and discharge, Mr. Hung suffered from a brain abscess complication, which was life-threatening.

On September 29, after more than 1 month of treatment at Nghe An General Hospital, patient Nghiem Xuan Hung (68 years old, residing in Nghia Dan district) was discharged and returned home.

In mid-August, patient Hung was admitted to the hospital with pus in his ear, severe headache, and very weak body. Through clinical examination and CT scan results, the patient was diagnosed with right mastoiditis with complications of right temporal lobe abscess. The condition was quite serious, requiring emergency surgery or else the patient's life would be threatened.

The patient received intensive treatment within 1 month after surgery.

After consulting with spinal neurologists and experts from the Central Ear, Nose and Throat Institute, doctors from Nghe An General Hospital decided to perform emergency surgery to remove lesions in the ear, mastoid bone, expose the meninges, veins to the healthy segment, and drain the brain abscess.

After surgery, the mortality rate remains at 40-50% so patients are treated and cared for in special conditions.

The patient's family said that about 50 years ago, after a bout of malaria, Mr. Hung discovered signs of pus coming out of his ear. Due to his subjectivity and difficult family economic conditions, he treated the disease at home by buying antibiotics to take himself. Unexpectedly, the ear infection did not improve but also caused complications to the skull and brain.

CT scan results of the patient's brain.

Doctor Tang Xuan Hai, head of the ENT department, said that for patients who are found to have ear infections and signs of pus discharge, they need to go to medical facilities for treatment and monitoring as soon as possible to avoid being subjective and causing brain abscess. If they are subjective, it can cause death at any time. Mr. Hung's case is the second patient in the past 5 years with a severe brain abscess due to ear infections to be treated at the hospital.

The cause of the disease is due to infections from the middle ear and mastoid bone, mainly through the following routes: Adjacent route: lesions spread to the intracranial surface of the mastoid bone, often cholesteatoma; Purulent labyrinthine inflammation route follows the endolymph to the brain; Blood route: venous route to the lateral vein, arterial route to the meningeal artery, thereby causing cerebral embolism; Natural route: open, not yet closed petrous joint space, often found in young children.

When suffering from a brain abscess due to the ear, the patient is always in a state of infection and fatigue. The condition of the ear often shows pus discharge, pressing on the mastoid area has a clear painful reaction, swelling or mastoid bone extrusion, hearing loss. In addition, there are symptoms of a brain abscess with manifestations such as episodic headaches, severe headaches accompanied by symptoms such as vomiting, slow communication, blurred vision on one side, prolonged fever, not high,...

To prevent the disease, the important measure for patients is to clean the nose and throat, prevent upper respiratory tract infections to prevent ear discharge. If ear discharge occurs, it is necessary to treat it thoroughly to avoid dangerous otitis media. In cases of dangerous otitis media, early treatment and surgery are needed, especially when there is cholesteatoma. Patients need to be detected early and treated for acute mastoiditis, expulsion as well as intracranial complications due to the ear, and transferred to emergency surgery to avoid complications and associated complications.

Hoang Yen

(Nghe An General Hospital)