Otogenic Cerebellar Abscesses: A Case Report with Its Chronological Findings

Although uncommon in the modern era of antimicrobial therapy , potentially lethal intracranial complications of acute and chronic otitis media still occur. We encountered a 53-year- old man with bilateral chronic otitis media who developed an abscess in the junction of the vermis and right hemisphere of the cerebellum. The patient presented with vertigo, intractable headache, exacerbation of otorrhea and down-beat nystagmus on electronystag-mography (ENG). However, the initial brain computed tomographic (CT) scan was negative. Unfortunately, the patient deteriorated to a state of drowsy consciousness in one month and the follow-up CT scan revealed a cerebellar abscess with impending herniation. Drainage of the abscess was performed immediately by a neurosurgeon. After the operation, the patient received intravenous antibiotic treatment for 6 weeks and was followed with serial CT scans weekly until the abscess resolved completely. We concluded that the diagnosis of otogenic intracranial complications should be based on a high index of suspicion and if necessary, repeated CT scans or magnetic resonance imaging (MRI) should be performed.