1988 Volume 81 Issue 11 Pages 1557-1562
Brain abscess and septicemia are life-threatening diseases, which are sometimes complications of chronic otitis media. This paper describes difficulties encountered in a 49-year-old male patient. It took a long time to establish the causative organism in spite of repeated cultures, and discontinuation of antibiotics to obtain positive cultures resulted in DIC and renal failure. The source of the septicemia was an epidural abscess, which developed after a radical mastoidectomy. Granulation tissue covering the epidural abscess looked healthy under high magnification of an operating microscope. The abscess could not be visualized with CT because of the pyramidal bone. The inflammation was controlled by resection of the epidural abscess and administration of chloramphenicol. The authors point out the local masking effect of antibiotics and advise early use of chloramphenicol when it is difficult to control intracranial infections.
