Complications of Chronic Suppurative Otitis Media: A Left Otogenic Brain Abscess and a right Mastoid Fistula

Chew, Yok Kuan; Cheong, Jack Pein; A, Khir; Brito-Mutunayagam, S; Prepageran, Narayanan

doi:10.1177/014556131209101006

Cited by 10 publications

(11 citation statements)

References 4 publications

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“…Pseudomonas aeruginosa is one of the leading causes of CSOM (Yeo et al, 2007; Dayasena et al, 2011; Madana et al, 2011; Afolabi et al, 2012). CSOM is one of the largest public health burdens worldwide leading to hearing loss and life-threatening central nervous system complications, including brain abscess and meningitis (Chew et al, 2012; Yorgancılar et al, 2013; Sun and Sun, 2014). There is an urgent need to develop new therapies to combat this disease and help prevent complications associated with it.…”

Section: Introductionmentioning

confidence: 99%

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

et al. 2016

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Otitis media (OM) is a broad term describing a group of infectious and inflammatory disorders of the middle ear. Despite antibiotic therapy, acute OM can progress to chronic suppurative otitis media (CSOM) characterized by ear drum perforation and purulent discharge. Pseudomonas aeruginosa is the most common pathogen associated with CSOM. Although, macrophages play an important role in innate immune responses but their role in the pathogenesis of P. aeruginosa-induced CSOM is not known. The objective of this study is to examine the interaction of P. aeruginosa with primary macrophages. We observed that P. aeruginosa enters and multiplies inside human and mouse primary macrophages. This bacterial entry in macrophages requires both microtubule and actin dependent processes. Transmission electron microscopy demonstrated that P. aeruginosa was present in membrane bound vesicles inside macrophages. Interestingly, deletion of oprF expression in P. aeruginosa abrogates its ability to survive inside macrophages. Our results suggest that otopathogenic P. aeruginosa entry and survival inside macrophages is OprF-dependent. The survival of bacteria inside macrophages will lead to evasion of killing and this lack of pathogen clearance by phagocytes contributes to the persistence of infection in CSOM. Understanding host–pathogen interaction will provide novel avenues to design effective treatment modalities against OM.

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Section: Introductionmentioning

confidence: 99%

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

et al. 2016

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“…13 Every year 28 000 deaths are attributable to OM complications, mainly through meningitis and brain abscess. 14,15 …”

Section: Introductionmentioning

confidence: 99%

Role of innate immunity in the pathogenesis of otitis media

Mittal

Kodiyan

Gerring

et al. 2014

International Journal of Infectious Diseases

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Summary Otitis media (OM) is a public health problem in both developed and developing countries. It is the leading cause of hearing loss and represents a significant healthcare burden. In some cases, acute OM progresses to chronic suppurative OM (CSOM), characterized by effusion and discharge, despite antimicrobial therapy. The emergence of antibiotic resistance and potential ototoxicity of antibiotics has created an urgent need to design non-conventional therapeutic strategies against OM based on modern insights into its pathophysiology. In this article, we review the role of innate immunity as it pertains to OM and discuss recent advances in understanding the role of innate immune cells in protecting the middle ear. We also discuss the mechanisms utilized by pathogens to subvert innate immunity and thereby overcome defensive responses. A better knowledge about bacterial virulence and host resistance promises to reveal novel targets to design effective treatment strategies against OM. The identification and characterization of small natural compounds that can boost innate immunity may provide new avenues for the treatment of OM. There is also a need to design novel methods for targeted delivery of these compounds into the middle ear, allowing higher therapeutic doses and minimizing systemic side effects.

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“…The anginosus streptococci may produce cerebral abscess by contiguous spread from a focal infection, such as: dental infections, sinusitis, mastoiditis, otitis media. 7,8 The frontal lobe is the main location of the brain abscess in most patients 9 , but the temporal lobe is more affected in case of otitis media complications 10 Pansinusitis may lead also to subperiosteal scalp abscess, epidural abscess and other intracranial abscess. 11 However, some brain abscesses develop as posttraumatic complications, including neurosurgery and other cranial trauma followed by wound infection and cerebritis.…”

Section: Constellatus S Intermedius or S Millerimentioning

confidence: 99%

Streptococcus anginosus group - brief characterization and its contribution to the brain abscess pathogenesis

Bancescu¹,

Băncescu²,

Constantinescu³

2015

EDUJ

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The oral streptococci are microorganisms whose major habitat is the oral cavity and oropharynx. The Streptococcus anginosus group, formerly known as Streptococcus milleri group, comprises the following commensal species: S. anginosus, S. constellatus and S. intermedius. Sometimes these species may produce different oral or extraoral infections, especially oro-maxillo-facial infections and deepseated abscess. Objective: The aim of the present article was to provide the reader with the essential knowledge about S. anginosus group characteristics and a useful updated review of its important contribution to develop brain abscess. Data sources and selection: The most important evidence concerning the recent taxonomical data, main phenotypical features and findings referring to the involvement of these bacteria in causing cerebral abscess in adults and children were collected from PubMed/Medline database. Only articles published between January 2011-November 2015 were selected and the significant data have been presented in a synthesized form, without performing a meta-analysis. Conclusion: The S. anginosus group merits greater attention from both clinicians and microbiologists due to its importance in human pathology, especially in life-threatening infections, like brain abscesses, which often require a multidisciplinary team for proper diagnosis and treatment.

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Complications of Chronic Suppurative Otitis Media: A Left Otogenic Brain Abscess and a right Mastoid Fistula

Abstract: Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that causeda lefttemporal lobe abscess and a right mastoidfistula.

Cited by 10 publications

References 4 publications

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

Otopathogenic Pseudomonas aeruginosa Enters and Survives Inside Macrophages

Role of innate immunity in the pathogenesis of otitis media

Streptococcus anginosus group - brief characterization and its contribution to the brain abscess pathogenesis

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