CNS complications of ear, nose and throat infections: An analysis of 50 consecutive cases

Sixty-four diverse central nervous system (CNS) complications were noted in a series of 50 patients initially suffering from an otorhinological infection. Thirty-five patients (70%) were in pediatric age groups (1-15 years). Twelve patients (24%) had more than one complication. Mortality rates were l6% in patients with one CNS complication and 25% in patients with multiple complications. Overall mortality rate was 18%. Leptomeningitis was the most common intracranial complication (42%) occurring, mainly in pediatric patients. Lateral sinus thrombosis (LST) was accompanied with other intracranial abnormalities in 72% of the cases. Brain abscess as an initial or concomitant complication was associated with the highest mortality rates (44%). Three of these fatal cases had multiple brain abscess. The rarity of intracranial suppurations secondary to ear and nose infections and the masking effect of the antibiotics bring difficulties in the early detection of CNS complications. Although the modern imaging techniques contribute to the recognition and localization of the intracranial pathology, the clinical investigation is still of paramount importance in detection of the original infection in the pneumatic spaces of the upper respiratory tract.