Patient presents with high fever, signs of raised ICT and a past history of chronic otitis media likely diagnosis is
Brain abscess develops through four stages. 1. Stage of invasion (initial encephalitis). It often passes unnoticed as symptoms are slight. Patient may have head-ache, low-grade fever, malaise and drowsiness. 2. Stage of localization (latent abscess). There are no symptoms during this stage. Nature tries to localize the pus by formation of a capsule. The stage may last for several weeks. 3. Stage of enlargement (manifest abscess). Abscess begins to enlarge. A zone of oedema appears round the abscess and is responsible for aggravation of symptoms. Clinical features at this stage are due to: (a) Raised intracranial tension. (b) Disturbance of function in the cerebrum or cerebellum, causing focal symptoms and signs. 4. Stage of termination (rupture of abscess). An expanding abscess in the white matter of brain ruptures into the ventricle or subarachnoid space resulting in fatal meningitis. Ref: Dhingra 7e pg 90.
Ear
Brain abscess
Pyogenic meningitis
Acute subarachnoid hemorrhage
Acute osteomyelitis of skull bone
Brain abscess