Pathogen spectrum in intracranial complications of sinugenic and otogenic origin

Introduction Intracranial complications are rare but serious and often threatening consequences of inflammations of the ear or paranasal sinuses. The aim of this study is to investigate the pathogen spectrum of intracranial complications and compare it with those of non-complicative sinusitis and otitis, which are well documented in the literature.

Material and methods A total of 37 cases of intracranial complications of sinugenic and otogenic inflammation were diagnosed and treated between 2012 und 2022. These cases were retrospectively examined regarding the spectrum of microbiological pathogens.

Results 19 of 37 cases (51%) were of otogenic, 15 (41%) of sinugenic origin and 3 (8%) cases had an inflammatory focus in both the sinuses and ear. Complications included meningitis in 23 (62%), duraempyema in 3 (8%), intracranial abscess in 3 (8%) and sigmoid sinus thrombosis in 3 (8%) cases. Subperiosteal abscess, cerebral abscess and cavernous sinus thrombosis were present in 1 (3%) case each. Staphylococci (n=16, 43%), Streptococci (n=10, 27%), Pseudomonas aeruginosa (n=4, 11%) and Cutibacterium acnes (n=2, 5%) were most frequently detected from the pre- or intraoperative specimens. In 13 cases (35%), no microorganisms were detected. The spectrum of pathogens detected corresponded to the known pathogen spectrum in uncomplicated sinusitis and otitis.

Conclusion Our data suggest that the underlying pathogen is not a determining or predictive factor for a complicative course. However, the identification of the pathogen remains decisive for the success of antibiotic therapy, which is together with surgical treatment the basis for the management of intracranial complications.

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Artikel online veröffentlicht:
19. April 2024