폐렴구균에 의한 급성 유양돌기염에서 합병된 경막외농양 1례 = A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused by Streptococcus pneumoniae

국문 초록 (Abstract)

중이염은 소아 연령에서 가장 흔한 감염 질환이다. 항생제 치료에도 불구하고 중이염과 중이염의 합병증이 아직도 흔하게 발생하고 있다. 급성 유양돌기염은 중이염의중증 합병증이며 경막외농양은 두개강 내에 발생하는 중이염의 합병증으로서 가장 많은 수를 차지한다. 급성 유양돌기염의 신경계 합병증은 흔하지 않지만 치명적일 수 있는데, 항생제의 사용으로 뚜렷한 증상이 보이지 않을 수있다.
저자들은 폐렴구균에 의한 중이염으로 입원해 급성 유양돌기염에서 경막외농양 및 외측정맥동의 혈전정맥염으로 진행했던 드문 증례를 경험하였기에 보고하는 바이다. 환자는 열을 동반한 중이염으로 입원하여 적절한 항생제를 투여하였으나, 유양돌기염과 경막외농양이 발생하여 수술적 배농과 항생제 투여 후 후유증 없이 호전되었다.

다국어 초록 (Multilingual Abstract)

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM,AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscessconstitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rarebut can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acuteotitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused byStreptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acutemastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recoveredwithout sequalae.

참고문헌 (Reference)

• 1 Givon-Lavi N, "Vaccination of daycare center attendees reduces carriage of Streptococcus pneumoniae among their younger siblings" 22 : 524-532, 2003
• 2 Park H, "Surgical management of acute mastoiditis with epidural abscess" 126 : 782-784, 2006
• 3 Zapalac JS, "Suppurative complications of acute otitis media in the era of antibiotic resistance" 128 : 660-663, 2002
• 4 Lahav J, "Postauricular needle aspiration of subperiosteal abscess in acute mastoiditis" 114 : 323-327, 2005
• 5 Holt GR, "Masked mastoiditis" 93 : 1034-1037, 1983
• 6 Goldstein NA, "Intratemporal complications of acute otitis media in infants and children" 119 : 444-454, 1998
• 7 Samuel J, "Intracranial otogenic complications: a persisting problem" 96 : 272-278, 1986
• 8 Kangsanarak J, "Intracranial complications of suppurative otitis media: 13 years' experience" 16 : 104-109, 1995
• 9 Proctor CA, "Intracranial complications of otitic origin" 76 : 288-308, 1966
• 10 Go C, "Intracranial complications of acute mastoiditis" 52 : 143-148, 2000
• 11 Gower D, "Intracranial complications of acute and chronic infectious ear disease: a problem still with us" 93 : 1028-1033, 1983
• 12 Millar EV, "Indirect effect of 7-valent pneumococcal conjugate vaccine on pneumococcal colonization among unvaccinated household members" 47 : 989-996, 2008
• 13 Taylor MF, "Indications for mastoidectomy in acute mastoiditis in children" 113 : 69-72, 2004
• 14 Kangsanarak J, "Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases" 107 : 999-1004, 1993
• 15 Pennybacker J, "Discussion on intracranial complications of otogenic origin" 54 : 309-320, 1961
• 16 Leskinen K, "Complications of acute otitis media in children" 5 : 308-312, 2005
• 17 Rosen A, "Acute mastoiditis: a review of 69 cases" 95 : 222-224, 1986
• 18 Luntz M, "Acute mastoiditis-revisited" 73 : 648-654, 1994