Background: Otogenic brain abscess is a rare but potentially life-threatening intracranial complication of otitis media and mastoid disease. Despite advances in neuroimaging, antimicrobial therapy, and surgical management, delayed diagnosis continues to contribute significantly to morbidity and mortality [1,2].
Objective: To review contemporary literature regarding the epidemiology, pathogenesis, microbiology, clinical presentation, diagnosis, and management of otogenic brain abscess.
Methods: A literature review in the English-language was conducted, focusing on systematic reviews, international clinical guidelines, and key observational studies related to otogenic brain abscess.
Results: Otogenic brain abscess most commonly arises from chronic suppurative otitis media, cholesteatoma, or acute mastoiditis and typically involves the temporal lobe or cerebellum. Magnetic resonance imaging with diffusion-weighted sequences is central to diagnosis. Management relies on prolonged intravenous antimicrobial therapy, neurosurgical drainage when indicated, and definitive otologic source control [1–4].
Conclusion: Otogenic brain abscess remains a serious complication of ear disease. Early recognition, prompt neuroimaging, microbiological diagnosis when feasible, and coordinated multidisciplinary management are essential to optimize outcomes.
Duarte MJ, Kozin ED, Barshak MB, Reinshagen KL, Remenschneider AK, Shah PV, et al. Otogenic brain abscesses: a systematic review. Laryngoscope Investig Otolaryngol. 2018;3(3):198–208.
Brouwer MC, Tunkel AR, McKhann GM II, van de Beek D. Brain abscess. N Engl J Med. 2014;371(5):447–56.
Bodilsen J, et al. ESCMID guidelines on diagnosis and treatment of brain abscess in children and adults. Clin Microbiol Infect. 2024;30:66–89.
Hafidh MA, Keogh I, Walsh RM, Walsh MA, Rawluk D, Hone S. Otogenic intracranial complications: a 7-year retrospective review. Am J Otolaryngol. 2006;27(6):390–5.
Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology. 2014;82(9):806–13.
Tung GA, Evangelista P, Rogg JM, Duncan JA. Diffusion-weighted MR imaging of rim-enhancing brain masses. AJR Am J Roentgenol. 2001;177(3):709–14.
Castellazzi ML, et al. Pediatric otogenic cerebral venous sinus thrombosis. Ital J Pediatr. 2020;46:1–8.
Hafidh MA, et al. Microbiology of otogenic intracranial complications. Am J Otolaryngol. 2006;27:390–5.
