Feussner Oskar, Haase Roland, Baier Jan
Department for Operative and Nonoperative Pediatrics and Adolescent Medicine, Section for Neonatology and Pediatric Critical Care, University Hospital, Halle, Germany.
Front Pediatr. 2023 Jan 23;10:1013300. doi: 10.3389/fped.2022.1013300. eCollection 2022.
We present the case of a 13-year-old boy who unexpectedly needed to be resuscitated at home after an assumed uncomplicated otitis media. Imaging at our clinic showed mastoiditis and a cystoid mass in the left cerebellopontine angle compressing the brainstem, as well as an Arnold-Chiari-Malformation. Both the laboratory examination of cerebrospinal fluid (CSF) and surgical biopsy with pathological evaluation of the mastoid supported the inflammatory etiology of the mass. Microbiologically, Streptococcus intermedius was detected in the blood culture and CSF. Due to brain death, which most likely already existed preclinically, the organs were released for donation during the course. Our case demonstrates a very rare lethal complication of acute otitis media on the basis of a cerebral malformation and emphasizes the need to stay alert when patients complain of symptoms after assumed resolution.
我们报告了一例13岁男孩的病例，该男孩在被认为是单纯性中耳炎后在家中意外需要进行心肺复苏。我们诊所的影像学检查显示乳突炎以及左侧小脑脑桥角有一个压迫脑干的囊样肿物，同时还有阿诺德-奇阿利畸形。脑脊液（CSF）的实验室检查以及对乳突进行手术活检并做病理评估均支持该肿物的炎症病因。在微生物学方面，血培养和脑脊液中检测到中间型链球菌。由于脑死亡（很可能在临床前期就已存在），在此过程中器官被用于捐赠。我们的病例展示了基于脑畸形的急性中耳炎一种非常罕见的致命并发症，并强调当患者在假定症状缓解后仍诉说症状时需要保持警惕。
