Temporal Lobe Brain Abscess Following Refractory Chronic Otitis Media Despite Repeated Antibiotic Therapy
DOI:
https://doi.org/10.65495/eurjimr.2026.18Keywords:
brain abscess, chronic otitis media, mastoiditis, otogenic infection, temporal lobeAbstract
Background: Brain abscess is a rare but potentially life-threatening intracranial infection. Despite advances in antimicrobial therapy and neuroimaging, otogenic brain abscesses remain clinically significant, particularly in patients with chronic otitis media and mastoiditis. Due to anatomical proximity, the temporal lobe is the most commonly affected region.
Case Presentation: A 25-year-old male presented to the emergency department with a 40-day history of left ear pain, purulent otorrhea, high-grade fever, and deterioration of general condition. The patient had a long-standing history of chronic otitis media and multiple recent emergency and otolaryngology visits, during which repeated topical, oral, and parenteral antibiotic treatments were administered. Neurological examination revealed neck stiffness and mild alteration of consciousness. Brain computed tomography demonstrated a 40×30 mm mass lesion in the left temporal lobe with surrounding edema and erosion of the temporal bone, consistent with a brain abscess. Broad-spectrum intravenous antibiotics were initiated, and the patient underwent urgent neurosurgical drainage followed by mastoidectomy. Microbiological cultures showed no growth. The patient improved clinically and was discharged with oral antibiotic therapy.
Conclusions: This case highlights that brain abscess may develop in patients with chronic otitis media and mastoiditis even in the absence of immunosuppression. In patients with refractory otologic infections and clinical deterioration, early neuroimaging and a multidisciplinary approach are essential for timely diagnosis and successful management.
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The data supporting the findings of this case report are not publicly available due to patient confidentiality but are available from the corresponding author upon reasonable request and with appropriate ethical approval.
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