PittsburghV1, Istex, Corpus, bibRecord, 001F94

Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis

Identifieur interne : 001F94 ( Istex/Corpus ); précédent : 001F93; suivant : 001F95

Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis

Auteurs : Steven A. Goldman ; Jennifer K. B. Ankerstjerne ; Keith B. Welker ; Douglas A. Chen

Source :

Otolaryngology - Head and Neck Surgery [ 0194-5998 ] ; 1998.

RBID : ISTEX:891923803958286D136A4BD1E10F148E7DE749BA

English descriptors

Abstract

Abstract: Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)

Url:

https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/pdf

DOI: 10.1016/S0194-5998(98)70367-5

Links to Exploration step

ISTEX:891923803958286D136A4BD1E10F148E7DE749BA

Le document en format XML

<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
<author><name sortKey="Goldman, Steven A" sort="Goldman, Steven A" uniqKey="Goldman S" first="Steven A." last="Goldman">Steven A. Goldman</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Ankerstjerne, Jennifer K B" sort="Ankerstjerne, Jennifer K B" uniqKey="Ankerstjerne J" first="Jennifer K. B." last="Ankerstjerne">Jennifer K. B. Ankerstjerne</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Welker, Keith B" sort="Welker, Keith B" uniqKey="Welker K" first="Keith B." last="Welker">Keith B. Welker</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Chen, Douglas A" sort="Chen, Douglas A" uniqKey="Chen D" first="Douglas A." last="Chen">Douglas A. Chen</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:891923803958286D136A4BD1E10F148E7DE749BA</idno>
<date when="1998" year="1998">1998</date>
<idno type="doi">10.1016/S0194-5998(98)70367-5</idno>
<idno type="url">https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/pdf</idno>
<idno type="wicri:Area/Istex/Corpus">001F94</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">001F94</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
<author><name sortKey="Goldman, Steven A" sort="Goldman, Steven A" uniqKey="Goldman S" first="Steven A." last="Goldman">Steven A. Goldman</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Ankerstjerne, Jennifer K B" sort="Ankerstjerne, Jennifer K B" uniqKey="Ankerstjerne J" first="Jennifer K. B." last="Ankerstjerne">Jennifer K. B. Ankerstjerne</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Welker, Keith B" sort="Welker, Keith B" uniqKey="Welker K" first="Keith B." last="Welker">Keith B. Welker</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Chen, Douglas A" sort="Chen, Douglas A" uniqKey="Chen D" first="Douglas A." last="Chen">Douglas A. Chen</name>
<affiliation><mods:affiliation>Pittsburgh, Pennsylvania</mods:affiliation>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Otolaryngology - Head and Neck Surgery</title>
<title level="j" type="abbrev">YMHN</title>
<idno type="ISSN">0194-5998</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1998">1998</date>
<biblScope unit="volume">118</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="page" from="6">6</biblScope>
<biblScope unit="page" to="8">8</biblScope>
</imprint>
<idno type="ISSN">0194-5998</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0194-5998</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Abscess</term>
<term>Antibiotic</term>
<term>Arch otolaryngol head neck surg</term>
<term>Auditory</term>
<term>Brain abscess</term>
<term>Canal</term>
<term>Chronic suppurative otitis media</term>
<term>Coalescent mastoiditis</term>
<term>Common intracranial complication</term>
<term>Complication</term>
<term>Dura</term>
<term>Early diagnosis</term>
<term>Early signs</term>
<term>External auditory canal</term>
<term>Extradural</term>
<term>Extradural abscess</term>
<term>Fistula</term>
<term>Foreign material</term>
<term>Fossa</term>
<term>Granulation</term>
<term>Granulation tissue</term>
<term>High index</term>
<term>Hydrocephalus</term>
<term>Intracranial</term>
<term>Intracranial complication</term>
<term>Intracranial complications</term>
<term>Labyrinth</term>
<term>Labyrinthine</term>
<term>Labyrinthine fistula</term>
<term>Lateral</term>
<term>Lateral aspect</term>
<term>Lateral sinus thrombosis</term>
<term>Malodorous</term>
<term>Malodorous otorrhea</term>
<term>Mastoid</term>
<term>Mastoid cavity</term>
<term>Mastoidectomy</term>
<term>Mastoiditis</term>
<term>Meningitis</term>
<term>Mental status</term>
<term>Neck surgery</term>
<term>Neurotologic complications</term>
<term>Nuchal rigidity</term>
<term>Otolaryngology</term>
<term>Otomastoiditis</term>
<term>Otorrhea</term>
<term>Posterior fossa dura</term>
<term>Purulent</term>
<term>Semicircular canal</term>
<term>Sinus</term>
<term>Such complications</term>
<term>Suppurative</term>
<term>Suppurative labyrinthitis</term>
<term>Thrombosis</term>
<term>Ventriculoperitoneal shunt</term>
<term>Vertigo</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Abscess</term>
<term>Antibiotic</term>
<term>Arch otolaryngol head neck surg</term>
<term>Auditory</term>
<term>Brain abscess</term>
<term>Canal</term>
<term>Chronic suppurative otitis media</term>
<term>Coalescent mastoiditis</term>
<term>Common intracranial complication</term>
<term>Complication</term>
<term>Dura</term>
<term>Early diagnosis</term>
<term>Early signs</term>
<term>External auditory canal</term>
<term>Extradural</term>
<term>Extradural abscess</term>
<term>Fistula</term>
<term>Foreign material</term>
<term>Fossa</term>
<term>Granulation</term>
<term>Granulation tissue</term>
<term>High index</term>
<term>Hydrocephalus</term>
<term>Intracranial</term>
<term>Intracranial complication</term>
<term>Intracranial complications</term>
<term>Labyrinth</term>
<term>Labyrinthine</term>
<term>Labyrinthine fistula</term>
<term>Lateral</term>
<term>Lateral aspect</term>
<term>Lateral sinus thrombosis</term>
<term>Malodorous</term>
<term>Malodorous otorrhea</term>
<term>Mastoid</term>
<term>Mastoid cavity</term>
<term>Mastoidectomy</term>
<term>Mastoiditis</term>
<term>Meningitis</term>
<term>Mental status</term>
<term>Neck surgery</term>
<term>Neurotologic complications</term>
<term>Nuchal rigidity</term>
<term>Otolaryngology</term>
<term>Otomastoiditis</term>
<term>Otorrhea</term>
<term>Posterior fossa dura</term>
<term>Purulent</term>
<term>Semicircular canal</term>
<term>Sinus</term>
<term>Such complications</term>
<term>Suppurative</term>
<term>Suppurative labyrinthitis</term>
<term>Thrombosis</term>
<term>Ventriculoperitoneal shunt</term>
<term>Vertigo</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Abstract: Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)</div>
</front>
</TEI>
<istex><corpusName>elsevier</corpusName>
<keywords><teeft><json:string>abscess</json:string>
<json:string>intracranial</json:string>
<json:string>meningitis</json:string>
<json:string>granulation</json:string>
<json:string>otorrhea</json:string>
<json:string>brain abscess</json:string>
<json:string>intracranial complications</json:string>
<json:string>mastoid</json:string>
<json:string>fistula</json:string>
<json:string>fossa</json:string>
<json:string>suppurative</json:string>
<json:string>purulent</json:string>
<json:string>extradural</json:string>
<json:string>mastoiditis</json:string>
<json:string>auditory</json:string>
<json:string>lateral</json:string>
<json:string>foreign material</json:string>
<json:string>hydrocephalus</json:string>
<json:string>malodorous</json:string>
<json:string>mastoidectomy</json:string>
<json:string>dura</json:string>
<json:string>labyrinthine</json:string>
<json:string>otolaryngology</json:string>
<json:string>otomastoiditis</json:string>
<json:string>early diagnosis</json:string>
<json:string>vertigo</json:string>
<json:string>labyrinthine fistula</json:string>
<json:string>mastoid cavity</json:string>
<json:string>lateral aspect</json:string>
<json:string>mental status</json:string>
<json:string>extradural abscess</json:string>
<json:string>granulation tissue</json:string>
<json:string>lateral sinus thrombosis</json:string>
<json:string>complication</json:string>
<json:string>canal</json:string>
<json:string>thrombosis</json:string>
<json:string>sinus</json:string>
<json:string>nuchal rigidity</json:string>
<json:string>high index</json:string>
<json:string>posterior fossa dura</json:string>
<json:string>intracranial complication</json:string>
<json:string>external auditory canal</json:string>
<json:string>ventriculoperitoneal shunt</json:string>
<json:string>common intracranial complication</json:string>
<json:string>such complications</json:string>
<json:string>early signs</json:string>
<json:string>arch otolaryngol head neck surg</json:string>
<json:string>chronic suppurative otitis media</json:string>
<json:string>neurotologic complications</json:string>
<json:string>malodorous otorrhea</json:string>
<json:string>suppurative labyrinthitis</json:string>
<json:string>semicircular canal</json:string>
<json:string>coalescent mastoiditis</json:string>
<json:string>neck surgery</json:string>
<json:string>labyrinth</json:string>
<json:string>antibiotic</json:string>
</teeft>
</keywords>
<author><json:item><name>Steven A. Goldman MD</name>
<affiliations><json:string>Pittsburgh, Pennsylvania</json:string>
</affiliations>
</json:item>
<json:item><name>Jennifer K.B. Ankerstjerne MD</name>
<affiliations><json:string>Pittsburgh, Pennsylvania</json:string>
</affiliations>
</json:item>
<json:item><name>Keith B. Welker MD</name>
<affiliations><json:string>Pittsburgh, Pennsylvania</json:string>
</affiliations>
</json:item>
<json:item><name>Douglas A. Chen MD</name>
<affiliations><json:string>Pittsburgh, Pennsylvania</json:string>
</affiliations>
</json:item>
</author>
<arkIstex>ark:/67375/6H6-9CMPD3TX-S</arkIstex>
<language><json:string>eng</json:string>
</language>
<originalGenre><json:string>Full-length article</json:string>
</originalGenre>
<abstract>Abstract: Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)</abstract>
<qualityIndicators><score>5.179</score>
<pdfWordCount>1799</pdfWordCount>
<pdfCharCount>11775</pdfCharCount>
<pdfVersion>1.3</pdfVersion>
<pdfPageCount>3</pdfPageCount>
<pdfPageSize>612 x 792 pts (letter)</pdfPageSize>
<refBibsNative>true</refBibsNative>
<abstractWordCount>115</abstractWordCount>
<abstractCharCount>769</abstractCharCount>
<keywordCount>0</keywordCount>
</qualityIndicators>
<title>Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
<pmid><json:string>9450821</json:string>
</pmid>
<pii><json:string>S0194-5998(98)70367-5</json:string>
</pii>
<genre><json:string>research-article</json:string>
</genre>
<host><title>Otolaryngology - Head and Neck Surgery</title>
<language><json:string>unknown</json:string>
</language>
<publicationDate>1998</publicationDate>
<issn><json:string>0194-5998</json:string>
</issn>
<pii><json:string>S0194-5998(05)X7081-4</json:string>
</pii>
<volume>118</volume>
<issue>1</issue>
<pages><first>6</first>
<last>8</last>
</pages>
<genre><json:string>journal</json:string>
</genre>
</host>
<namedEntities><unitex><date><json:string>1998</json:string>
</date>
<geogName></geogName>
<orgName></orgName>
<orgName_funder></orgName_funder>
<orgName_provider></orgName_provider>
<persName></persName>
<placeName></placeName>
<ref_url></ref_url>
<ref_bibl><json:string>Schwaber et al.</json:string>
<json:string>Samuel et al.</json:string>
</ref_bibl>
<bibl></bibl>
</unitex>
</namedEntities>
<ark><json:string>ark:/67375/6H6-9CMPD3TX-S</json:string>
</ark>
<categories><wos><json:string>1 - science</json:string>
<json:string>2 - surgery</json:string>
<json:string>2 - otorhinolaryngology</json:string>
</wos>
<scienceMetrix><json:string>1 - health sciences</json:string>
<json:string>2 - clinical medicine</json:string>
<json:string>3 - otorhinolaryngology</json:string>
</scienceMetrix>
<scopus><json:string>1 - Health Sciences</json:string>
<json:string>2 - Medicine</json:string>
<json:string>3 - Otorhinolaryngology</json:string>
<json:string>1 - Health Sciences</json:string>
<json:string>2 - Medicine</json:string>
<json:string>3 - Surgery</json:string>
</scopus>
<inist><json:string>1 - sciences appliquees, technologies et medecines</json:string>
<json:string>2 - sciences biologiques et medicales</json:string>
<json:string>3 - sciences medicales</json:string>
<json:string>4 - otorhinolaryngologie. stomatologie</json:string>
</inist>
</categories>
<publicationDate>1998</publicationDate>
<copyrightDate>1998</copyrightDate>
<doi><json:string>10.1016/S0194-5998(98)70367-5</json:string>
</doi>
<id>891923803958286D136A4BD1E10F148E7DE749BA</id>
<score>1</score>
<fulltext><json:item><extension>pdf</extension>
<original>true</original>
<mimetype>application/pdf</mimetype>
<uri>https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/pdf</uri>
</json:item>
<json:item><extension>zip</extension>
<original>false</original>
<mimetype>application/zip</mimetype>
<uri>https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/zip</uri>
</json:item>
<istex:fulltextTEI uri="https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
</titleStmt>
<publicationStmt><authority>ISTEX</authority>
<publisher>ELSEVIER</publisher>
<availability><p>©1998 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc</p>
</availability>
<date>1998</date>
</publicationStmt>
<notesStmt><note>From the Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, and Department of Surgery, Medical College of Pennsylvania (Dr. Chen), Hahneman Medical School.</note>
<note>Reprint requests: Douglas Chen, MD, Pittsburgh Ear Associates, Suite 402, East Wing, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA 15212.</note>
<note>Reprint no. 23/1/75686</note>
</notesStmt>
<sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
<author xml:id="author-0000"><persName><forename type="first">Steven A.</forename>
<surname>Goldman</surname>
</persName>
<roleName type="degree">MD</roleName>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
</author>
<author xml:id="author-0001"><persName><forename type="first">Jennifer K.B.</forename>
<surname>Ankerstjerne</surname>
</persName>
<roleName type="degree">MD</roleName>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
</author>
<author xml:id="author-0002"><persName><forename type="first">Keith B.</forename>
<surname>Welker</surname>
</persName>
<roleName type="degree">MD</roleName>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
</author>
<author xml:id="author-0003"><persName><forename type="first">Douglas A.</forename>
<surname>Chen</surname>
</persName>
<roleName type="degree">MD</roleName>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
</author>
<idno type="istex">891923803958286D136A4BD1E10F148E7DE749BA</idno>
<idno type="DOI">10.1016/S0194-5998(98)70367-5</idno>
<idno type="PII">S0194-5998(98)70367-5</idno>
</analytic>
<monogr><title level="j">Otolaryngology - Head and Neck Surgery</title>
<title level="j" type="abbrev">YMHN</title>
<idno type="pISSN">0194-5998</idno>
<idno type="PII">S0194-5998(05)X7081-4</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1998"></date>
<biblScope unit="volume">118</biblScope>
<biblScope unit="issue">1</biblScope>
<biblScope unit="page" from="6">6</biblScope>
<biblScope unit="page" to="8">8</biblScope>
</imprint>
</monogr>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><creation><date>1998</date>
</creation>
<langUsage><language ident="en">en</language>
</langUsage>
<abstract xml:lang="en"><p>Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)</p>
</abstract>
</profileDesc>
<revisionDesc><change when="1998">Published</change>
</revisionDesc>
</teiHeader>
</istex:fulltextTEI>
<json:item><extension>txt</extension>
<original>false</original>
<mimetype>text/plain</mimetype>
<uri>https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/fulltext/txt</uri>
</json:item>
</fulltext>
<metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration>
<istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity>
<istex:entity SYSTEM="gr2" NDATA="IMAGE" name="gr2"></istex:entity>
</istex:docType>
<istex:document><article docsubtype="fla" xml:lang="en"><item-info><jid>YMHN</jid>
<aid>75686</aid>
<ce:pii>S0194-5998(98)70367-5</ce:pii>
<ce:doi>10.1016/S0194-5998(98)70367-5</ce:doi>
<ce:copyright type="other" year="1998">American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc</ce:copyright>
</item-info>
<head><ce:article-footnote><ce:label>☆</ce:label>
<ce:note-para>From the Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, and Department of Surgery, Medical College of Pennsylvania (Dr. Chen), Hahneman Medical School.</ce:note-para>
</ce:article-footnote>
<ce:article-footnote><ce:label>☆☆</ce:label>
<ce:note-para>Reprint requests: Douglas Chen, MD, Pittsburgh Ear Associates, Suite 402, East Wing, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA 15212.</ce:note-para>
</ce:article-footnote>
<ce:article-footnote><ce:label>★</ce:label>
<ce:note-para>Reprint no. <ce:bold>23/1/75686</ce:bold>
</ce:note-para>
</ce:article-footnote>
<ce:title>Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</ce:title>
<ce:author-group><ce:author><ce:given-name>Steven A.</ce:given-name>
<ce:surname>Goldman</ce:surname>
<ce:degrees>MD</ce:degrees>
</ce:author>
<ce:author><ce:given-name>Jennifer K.B.</ce:given-name>
<ce:surname>Ankerstjerne</ce:surname>
<ce:degrees>MD</ce:degrees>
</ce:author>
<ce:author><ce:given-name>Keith B.</ce:given-name>
<ce:surname>Welker</ce:surname>
<ce:degrees>MD</ce:degrees>
</ce:author>
<ce:author><ce:given-name>Douglas A.</ce:given-name>
<ce:surname>Chen</ce:surname>
<ce:degrees>MD</ce:degrees>
</ce:author>
<ce:affiliation><ce:textfn>Pittsburgh, Pennsylvania</ce:textfn>
</ce:affiliation>
</ce:author-group>
<ce:abstract><ce:section-title>Abstract</ce:section-title>
<ce:abstract-sec><ce:simple-para>Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)</ce:simple-para>
</ce:abstract-sec>
</ce:abstract>
</head>
<body><ce:sections><ce:para>The complications of otomastoiditis are well described. They can be classified into aural and intracranial complications. Aural complications include coalescent mastoiditis, subperiosteal abscess, petrositis, labyrinthitis, facial paralysis, and Bezold's abscess. Intracranial complications include meningitis, brain abscess, extradural abscess, lateral sinus thrombophlebitis or thrombosis, and otitic hydrocephalus.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup>
</ce:cross-ref>
 In the antibiotic era, such complications are uncommon, yet the potential sequelae are devastating. Early diagnosis is the key to minimizing these sequelae. We present a case of fatal anaerobic meningitis and brain abscess caused by otomastoiditis that resulted from foreign-body material placed in the ear by the patient. We believe this to be the only reported case of foreign body–induced mastoiditis with intracranial complications in the English literature.</ce:para>
<ce:section><ce:section-title>Case Report</ce:section-title>
<ce:para>A 51-year-old woman with a history of right mastoidectomy, hypertension, tuberculosis, and alcohol abuse was seen by her local physician with left otorrhea. She also had a history of persistent use of cotton swabs to clean her external auditory canals. She was treated with amoxicillin and initially lost to follow-up. She returned 1 month later with persistent left otorrhea, accompanied by fever and vertigo. She was given amoxicillin clavulanate and referred to a local otolaryngologist, who saw the patient the following day. By that time, the patient was beginning to show decreased sensorium, left facial paresis, and nuchal rigidity. She was admitted to a local hospital. Lumbar puncture revealed a cerebrospinal fluid (CSF) leukocytosis (491 leukocytes/mm<ce:sup>3</ce:sup>
, 91% neutrophils). Gram's stain showed no organisms. The patient was given intravenous vancomycin and ceftazidime, as well as diphenylhydantoin. Her mental status continued to deteriorate, and seizure activity took place despite prophylaxis. Two days after her admission, the patient was transferred to a nearby tertiary care facility for further diagnosis and treatment.</ce:para>
<ce:para>On transfer, the patient was lethargic but arousable and able to follow simple commands. She was hemodynamically stable but had an oral temperature of 38.3° C. She had a House grade IV/VI left facial palsy, nuchal rigidity, horizontal nystagmus to the right, and purulent left otorrhea with an obstructive left external auditory canal granulation polyp. White blood cell count was 24,000/mm<ce:sup>3</ce:sup> with a left shift. Computed tomography (CT) scan of the head from the outlying hospital showed soft-tissue density in the left external auditory canal, middle ear, and mastoid cavity, with coalescent mastoiditis, ossicular erosion, and erosion of the lateral aspect of the horizontal semicircular canal. There was also a large fluid density in the posteroinferior aspect of the mastoid tip, just lateral to posterior cranial fossa dura (Figs. 1 and 2).
<ce:display><ce:figure><ce:label>Fig. 1</ce:label>
<ce:caption><ce:simple-para>Noncontrast axial CT of the head with bone algorithm shows soft-tissue density in the left mastoid cavity with destruction of the normal bony septations. Bone over lateral aspect of horizontal semicircular canal has been eroded. No ossicles can be seen. Also note that the patient had a previous right mastoidectomy; there is no evidence of infection on the right.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr1"></ce:link>
</ce:figure>
</ce:display>
<ce:display><ce:figure><ce:label>Fig. 2</ce:label>
<ce:caption><ce:simple-para>On a lower image, note bone erosion and fluid density in mastoid tip, over posterior fossa. This was initially thought to be a possible site of entry for pathogens. Although this area was noted to contain loculated purulent fluid collection intraoperatively, posterior fossa dura was intact and without granulation, suggesting that this was not the route of entry.</ce:simple-para>
</ce:caption>
 <ce:link locator="gr2"></ce:link>
</ce:figure>
</ce:display>
</ce:para>
<ce:para>The patient's intravenous antibiotic regimen was changed to nafcillin, cefotaxime, and metronidazole as a result of spinal fluid cultures, which grew <ce:italic>Peptostreptococcus</ce:italic>
 and <ce:italic>Bacteroides</ce:italic>
 species. After being medically stabilized, the patient was taken to the operating room for emergency exploration of the left ear. A large granulation polyp was removed from the lateral aspect of the external auditory canal, revealing cotton fibers and wood splinters in the medial canal. It appeared as though cotton-swab tips had been broken off in the ear by the patient. This foreign material extended into the mesotympanum and epitympanum. No remnant of the tympanic membrane or ossicles was found. As the foreign material was debrided, the oval and round windows were identified. A radical mastoidectomy was performed. The mastoid was filled with granulation tissue and purulent debris. The fallopian canal appeared intact, and the facial nerve was successfully stimulated with a nerve stimulator. The horizontal and posterior semicircular canals were covered with granulation; no attempt was made to uncover the fistula site noted on the CT scan. A loculation of purulent fluid was found superficial to posterior fossa dura, but the dura was intact and without overlying granulation.</ce:para>
<ce:para>Postoperatively the patient developed hydrocephalus, necessitating placement of a ventriculostomy catheter. Mental status gradually improved, but CSF leukocytosis persisted. A magnetic resonance scan of the brain was obtained and showed a left cerebellar brain abscess. There was no sign of venous sinus thrombosis. The abscess was drained by CT-guided stereotactic biopsy. Microbial stains of the aspirate were negative, but cultures grew <ce:italic>Streptococcus</ce:italic>
, which was treated with vancomycin. The patient underwent placement of a ventriculoperitoneal shunt for persistent hydrocephalus.</ce:para>
<ce:para>She was transferred to an inpatient rehabilitation unit. Left otorrhea recurred, and the patient was found to have fragments of Kleenex and cotton balls in her left mastoid cavity. The patient apparently inserted the foreign material herself. Her otorrhea resolved after bedside debridement and treatment with topical antibiotic drops.</ce:para>
<ce:para>The patient was ultimately transferred to an outlying rehabilitation facility but again had decreased mental status and was transferred back to the emergency department, where head CT revealed recurrent hydrocephalus. She underwent revision of her ventriculoperitoneal shunt; however, her early postoperative course was complicated by distal shunt malfunction, resulting in fatal cerebral herniation.</ce:para>
</ce:section>
<ce:section><ce:section-title>Discussion</ce:section-title>
<ce:para>Previous retrospective series suggest that meningitis is the most common intracranial complication of infectious ear disease, followed by brain abscess. Both occurred in this patient. Gower and McGuirt<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup>
</ce:cross-ref>
 reviewed 100 cases involving intracranial complications of middle ear disease. Of these cases, 73 resulted from acute otitis media. In 76 patients, meningitis developed. In 6, brain abscess developed. There were five cases each of extradural effusion, otitic hydrocephalus, and lateral sinus thrombosis. In 3 patients, extradural abscesses developed. Of those with meningitis, 12% died. One patient with a brain abscess died. There were no other deaths. Mortality was thus 13% overall.<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup>
</ce:cross-ref>
 The authors concluded that early diagnosis and treatment of complications were critical to minimizing morbidity. However, the overall mortality from intracranial complications was essentially unchanged compared with studies from the preantibiotic era. This suggests a degree of irreversibility once such complications commence.</ce:para>
<ce:para>Samuel et al.<ce:cross-ref refid="bib3"><ce:sup>3</ce:sup>
</ce:cross-ref>
 reviewed 335 cases of complicated acute mastoiditis; 224 patients had intracranial complications. Again, meningitis was the most common intracranial complication (37%), followed by brain abscess (24%), extradural abscess (22%), and lateral sinus thrombosis (17%). Mortality was 8% for meningitis, 36% for brain abscess, 4% for extradural abscess, 10% for lateral sinus thrombosis, and 14% overall.<ce:cross-ref refid="bib3"><ce:sup>3</ce:sup>
</ce:cross-ref>
 The patients in this study were predominantly poor and had limited access to health care. The authors therefore concluded that, in the antibiotic era, low socioeconomic status is a risk factor for developing complications of mastoiditis.</ce:para>
<ce:para>In his review of the literature, Neely<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup>
</ce:cross-ref>
 emphasized early diagnosis as the key to improving patient outcome in cases of complicated temporal bone infections. However, early diagnosis of intracranial complications is difficult, because early signs are often subtle. Schwaber et al.<ce:cross-ref refid="bib4"><ce:sup>4</ce:sup>
</ce:cross-ref>
 reviewed 12 cases of chronic suppurative otitis media with neurotologic complications; the authors attempted to identify early warning signs by analyzing symptoms noted on the day before hospital admission. Nine of 12 patients had malodorous, purulent otorrhea, but for most, this had been a long-standing or recurrent problem, not a new sign. Seven of 12 complained of headache or deep ear pain, which was generally a new symptom. Three of 12 patients had fever. One of 12 had vertigo. Four of 12 had visible granulation tissue on otoscopy.<ce:cross-ref refid="bib4"><ce:sup>4</ce:sup>
</ce:cross-ref>
 From this study, we could argue that any patient with chronic suppurative ear disease with new fever, headache, ear pain, or in particular, vertigo should be treated with a high index of suspicion. Furthermore, malodorous otorrhea and the presence of granulation tissue suggest an aggressive infection that should be treated accordingly.</ce:para>
<ce:para>In our case, fever and vertigo might have been interpreted as warning signs of an evolving intracranial complication, especially in light of the patient's history of prolonged malodorous otorrhea and the finding of a large external auditory canal granulation polyp. From the CT findings (Fig. 1), it is likely that the patient's vertigo resulted from development of suppurative labyrinthitis as bacteria from the infected mastoid penetrated the membranous horizontal semicircular canal, although it is also possible that vertigo resulted from perilymph leakage when the bony horizontal canal was initially eroded. In either case, it is likely that the route of entry of bacteria into the central nervous system was the inner ear. Specifically, the cochlear aqueduct was most likely the route of spread from labyrinth to meninges. The association of meningitis with labyrinthine fistulae has been previously described in cases of cholesteatoma.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup>
</ce:cross-ref>
 The ability of cholesteatomas to cause a fistula of the labyrinth has been well described. The lateral semicircular canal is most commonly involved.<ce:cross-refs refid="bib5 bib6 bib7"><ce:sup>5-7</ce:sup>
</ce:cross-refs>
 Associated meningitis is unusual, suggesting that the membranous labyrinth poses a significant barrier to the migration of bacteria. There are few data in the literature concerning the question of whether a labyrinthectomy is required if suppurative labyrinthitis develops after a semicircular canal has been eroded by an infectious process. Thus it is unclear whether our patient would have benefited from a total labyrinthectomy to eradicate infection in the labyrinth. However, a mastoidectomy was clearly necessary to eliminate the primary locus of infection and to achieve adequate drainage.</ce:para>
</ce:section>
</ce:sections>
</body>
<tail><ce:bibliography><ce:section-title>References</ce:section-title>
<ce:bibliography-sec><ce:bib-reference id="bib1"><ce:label>1</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>JG.</ce:given-name>
<ce:surname>Neely</ce:surname>
</sb:author>
</sb:authors>
</sb:contribution>
<sb:host><sb:edited-book><sb:title><sb:maintitle>Otolaryngology, head and neck surgery</sb:maintitle>
</sb:title>
<sb:edition>2nd ed</sb:edition>
<sb:date>1993</sb:date>
<sb:publisher><sb:name>Mosby–Year Book, Inc</sb:name>
<sb:location>St. Louis</sb:location>
</sb:publisher>
</sb:edited-book>
<sb:pages><sb:first-page>2840</sb:first-page>
<sb:last-page>2864</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib2"><ce:label>2</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>D</ce:given-name>
<ce:surname>Gower</ce:surname>
</sb:author>
<sb:author><ce:given-name>WF.</ce:given-name>
<ce:surname>McGuirt</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>Intracranial complications of acute and chronic infectious ear disease: a problem still with us</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Laryngoscope</sb:maintitle>
</sb:title>
<sb:volume-nr>93</sb:volume-nr>
</sb:series>
<sb:date>1983</sb:date>
</sb:issue>
<sb:pages><sb:first-page>1028</sb:first-page>
<sb:last-page>1033</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib3"><ce:label>3</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>J</ce:given-name>
<ce:surname>Samuel</ce:surname>
</sb:author>
<sb:author><ce:given-name>CMC</ce:given-name>
<ce:surname>Fernandes</ce:surname>
</sb:author>
<sb:author><ce:given-name>JL.</ce:given-name>
<ce:surname>Steinberg</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>Intracranial otogenic complications: a persisting problem</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Laryngoscope</sb:maintitle>
</sb:title>
<sb:volume-nr>96</sb:volume-nr>
</sb:series>
<sb:date>1986</sb:date>
</sb:issue>
<sb:pages><sb:first-page>272</sb:first-page>
<sb:last-page>278</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib4"><ce:label>4</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>MK</ce:given-name>
<ce:surname>Schwaber</ce:surname>
</sb:author>
<sb:author><ce:given-name>ML</ce:given-name>
<ce:surname>Pensak</ce:surname>
</sb:author>
<sb:author><ce:given-name>LJ.</ce:given-name>
<ce:surname>Bartels</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>The early signs and symptoms of neurotologic complications of chronic suppurative otitis media</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Laryngoscope</sb:maintitle>
</sb:title>
<sb:volume-nr>99</sb:volume-nr>
</sb:series>
<sb:date>1989</sb:date>
</sb:issue>
<sb:pages><sb:first-page>373</sb:first-page>
<sb:last-page>375</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib5"><ce:label>5</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name>
<ce:surname>Kobayashi</ce:surname>
</sb:author>
<sb:author><ce:given-name>T</ce:given-name>
<ce:surname>Sato</ce:surname>
</sb:author>
<sb:author><ce:given-name>M</ce:given-name>
<ce:surname>Toshima</ce:surname>
</sb:author>
<sb:author><ce:given-name>M</ce:given-name>
<ce:surname>Ishidoya</ce:surname>
</sb:author>
<sb:author><ce:given-name>M</ce:given-name>
<ce:surname>Suetake</ce:surname>
</sb:author>
<sb:author><ce:given-name>T.</ce:given-name>
<ce:surname>Takasaka</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>Treatment of labyrinthine fistula with interruption of the semicircular canals</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Arch Otolaryngol Head Neck Surg</sb:maintitle>
</sb:title>
<sb:volume-nr>121</sb:volume-nr>
</sb:series>
<sb:date>1995</sb:date>
</sb:issue>
<sb:pages><sb:first-page>469</sb:first-page>
<sb:last-page>475</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib6"><ce:label>6</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>T</ce:given-name>
<ce:surname>Palva</ce:surname>
</sb:author>
<sb:author><ce:given-name>H.</ce:given-name>
<ce:surname>Ramsay</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>Treatment of labyrinthine fistula</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Arch Otolaryngol Head Neck Surg</sb:maintitle>
</sb:title>
<sb:volume-nr>115</sb:volume-nr>
</sb:series>
<sb:date>1989</sb:date>
</sb:issue>
<sb:pages><sb:first-page>804</sb:first-page>
<sb:last-page>806</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
<ce:bib-reference id="bib7"><ce:label>7</ce:label>
<sb:reference><sb:contribution><sb:authors><sb:author><ce:given-name>PK.</ce:given-name>
<ce:surname>Gormley</ce:surname>
</sb:author>
</sb:authors>
<sb:title><sb:maintitle>Surgical management of labyrinthine fistula with cholesteatoma</sb:maintitle>
</sb:title>
</sb:contribution>
<sb:host><sb:issue><sb:series><sb:title><sb:maintitle>J Laryngol Otol</sb:maintitle>
</sb:title>
<sb:volume-nr>100</sb:volume-nr>
</sb:series>
<sb:date>1986</sb:date>
</sb:issue>
<sb:pages><sb:first-page>1115</sb:first-page>
<sb:last-page>1123</sb:last-page>
</sb:pages>
</sb:host>
</sb:reference>
</ce:bib-reference>
</ce:bibliography-sec>
</ce:bibliography>
</tail>
</article>
</istex:document>
</istex:metadataXml>
<mods version="3.6"><titleInfo lang="en"><title>Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
</titleInfo>
<titleInfo type="alternative" lang="en" contentType="CDATA"><title>Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis</title>
</titleInfo>
<name type="personal"><namePart type="given">Steven A.</namePart>
<namePart type="family">Goldman</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Jennifer K.B.</namePart>
<namePart type="family">Ankerstjerne</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Keith B.</namePart>
<namePart type="family">Welker</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Douglas A.</namePart>
<namePart type="family">Chen</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Pittsburgh, Pennsylvania</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre type="research-article" displayLabel="Full-length article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre>
<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">1998</dateIssued>
<copyrightDate encoding="w3cdtf">1998</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
</language>
<abstract lang="en">Abstract: Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. The key to minimizing the morbidity of complications of infectious ear disease is early recognition and treatment. Early symptoms of complication include vertigo, new onset of headache or otalgia, or worsening headache or otalgia. Fever, malodorous ear drainage, and the presence of granulation tissue are warning findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease. (Otolaryngol Head Neck Surg 1998;118:6-8.)</abstract>
<note>From the Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, and Department of Surgery, Medical College of Pennsylvania (Dr. Chen), Hahneman Medical School.</note>
<note>Reprint requests: Douglas Chen, MD, Pittsburgh Ear Associates, Suite 402, East Wing, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA 15212.</note>
<note>Reprint no. 23/1/75686</note>
<relatedItem type="host"><titleInfo><title>Otolaryngology - Head and Neck Surgery</title>
</titleInfo>
<titleInfo type="abbreviated"><title>YMHN</title>
</titleInfo>
<genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre>
<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">199801</dateIssued>
</originInfo>
<identifier type="ISSN">0194-5998</identifier>
<identifier type="PII">S0194-5998(05)X7081-4</identifier>
<part><date>199801</date>
<detail type="volume"><number>118</number>
<caption>vol.</caption>
</detail>
<detail type="issue"><number>1</number>
<caption>no.</caption>
</detail>
<extent unit="issue-pages"><start>1</start>
<end>141</end>
</extent>
<extent unit="pages"><start>6</start>
<end>8</end>
</extent>
</part>
</relatedItem>
<identifier type="istex">891923803958286D136A4BD1E10F148E7DE749BA</identifier>
<identifier type="ark">ark:/67375/6H6-9CMPD3TX-S</identifier>
<identifier type="DOI">10.1016/S0194-5998(98)70367-5</identifier>
<identifier type="PII">S0194-5998(98)70367-5</identifier>
<accessCondition type="use and reproduction" contentType="copyright">©1998 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc</accessCondition>
<recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-HKKZVM7B-M">elsevier</recordContentSource>
<recordOrigin>American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc, ©1998</recordOrigin>
</recordInfo>
</mods>
<json:item><extension>json</extension>
<original>false</original>
<mimetype>application/json</mimetype>
<uri>https://api.istex.fr/document/891923803958286D136A4BD1E10F148E7DE749BA/metadata/json</uri>
</json:item>
</metadata>
<serie></serie>
</istex>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Istex/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001F94 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 001F94 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Amérique
   |area=    PittsburghV1
   |flux=    Istex
   |étape=   Corpus
   |type=    RBID
   |clé=     ISTEX:891923803958286D136A4BD1E10F148E7DE749BA
   |texte=   Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis
}}

This area was generated with Dilib version V0.6.38.
Data generation: Fri Jun 18 17:37:45 2021. Site generation: Fri Jun 18 18:15:47 2021

	Serveur d'exploration sur Pittsburgh
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration sur Pittsburgh

Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis

Fatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis

Source :

English descriptors

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri