Abstract

FERREIRA, Joana Oliveira; TINOCO, Inês Simões  and  FERNANDES, Joana. Bacterial meningitis: unexpected complication of acute otitis media. Rev Port Med Geral Fam [online]. 2018, vol.34, n.5, pp.317-321. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v34i5.12006.

Introduction: Acute otitis media is a common pathology in primary care. It rarely presents with complications, but when they occur they are serious and have considerable morbidity and mortality. This article aims to describe a case of acute meningitis secondary to acute otitis media, and its implications for the health and quality of life of the patient and his family. Case description: A 42-year-old male, active, belonging to a nuclear family, who turned to the family physician due to inaugural presentation of acute otitis and sinusitis, with symptoms of low intensity. Three days after the onset of symptoms, rapid clinical deterioration occurred, with worsening of the general health status. The patient was admitted to the emergency department in comatose state, with pyrexia and convulsive crisis. In the emergency department, additional tests were performed, such as lumbar puncture, computerized tomography and angiotomography that confirmed the diagnosis of acute bacterial meningitis caused by Streptococcus pneumoniae and right cerebellar stroke, both secondary to acute otitis media. Comments: Acute otitis media can be observed in different stages of its clinical presentation. When it progresses to mastoiditis, it can culminate in meningitis and cerebral venous sinus thrombosis. This case describes the clinical evolution of a complicated diagnosis of acute otitis media. It addresses the critical role of the family doctor managing disease, enhancing the articulation between primary and secondary health care, and in the rehabilitation of the patient and follow-up of the family. It also warns of the importance of empowering patients on the detection of signs and symptoms that deviate from the expected clinical evolution.

Keywords : Acute otitis media; Meningitis; Family dynamics.

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