{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:00Z","timestamp":1753891920499,"version":"3.41.2"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>We present the case of a 13-year-old boy who unexpectedly needed to be resuscitated at home after an assumed uncomplicated otitis media. Imaging at our clinic showed mastoiditis and a cystoid mass in the left cerebellopontine angle compressing the brainstem, as well as an Arnold-Chiari-Malformation. Both the laboratory examination of cerebrospinal fluid (CSF) and surgical biopsy with pathological evaluation of the mastoid supported the inflammatory etiology of the mass. Microbiologically, Streptococcus intermedius was detected in the blood culture and CSF. Due to brain death, which most likely already existed preclinically, the organs were released for donation during the course. Our case demonstrates a very rare lethal complication of acute otitis media on the basis of a cerebral malformation and emphasizes the need to stay alert when patients complain of symptoms after assumed resolution.<\/jats:p>","DOI":"10.3389\/fped.2022.1013300","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T15:05:05Z","timestamp":1674486305000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case report: Otitis media with subsequent mastoiditis and cerebral herniation in a patient with Arnold chiari malformation"],"prefix":"10.3389","volume":"10","author":[{"given":"Oskar","family":"Feussner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Haase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Baier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1016\/j.ijporl.2014.09.032","article-title":"Intratemporal and intracranial complications of acute otitis media in a pediatric population","volume":"78","author":"Mattos","year":"2014","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1097\/00006454-200102000-00004","article-title":"National differences in incidence of acute mastoiditis: relationship to prescribing patterns of antibiotics for acute otitis media?","volume":"20","author":"Van Zuijlen","year":"2001","journal-title":"Pediatr Infect Dis J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1494","DOI":"10.1016\/j.ijporl.2012.07.002","article-title":"Acute mastoiditis in children aged 0\u201316 years\u2014a national study of 678 cases in Sweden comparing different age groups","volume":"76","author":"Groth","year":"2012","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0165-5876(98)00080-9","article-title":"Acute mastoidectomy in a danish county from 1977 to 1996 with focus on the bacteriology","volume":"45","author":"Gregers Petersen","year":"1998","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1017\/S0022215117001840","article-title":"Management of paediatric acute mastoiditis: systematic review","volume":"132","author":"Loh","year":"2018","journal-title":"J Laryngol Otol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1879","DOI":"10.1542\/peds.2005-2470","article-title":"Trends in doctor consultations, antibiotic prescription, and specialist referrals for Otitis Media in children: 1995\u20132003","volume":"117","author":"Plasschaert","year":"2006","journal-title":"Pediatrics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1001\/jama.2009.1163","article-title":"Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings","volume":"302","author":"Grijalva","year":"2009","journal-title":"JAMA"},{"key":"B8","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/S0194-5998(01)00309-6","article-title":"Implications of the AHRQ evidence report on acute Otitis Media","volume":"125","author":"Rosenfeld","year":"2001","journal-title":"Otolaryngol Neck Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1542\/peds.2007-3349","article-title":"Effect of antibiotics for Otitis Media on mastoiditis in children: a retrospective cohort study using the United Kingdom general practice research database","volume":"123","author":"Thompson","year":"2009","journal-title":"Pediatrics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1097\/00005537-200310000-00004","article-title":"Natural history of untreated otitis media","volume":"113","author":"Rosenfeld","year":"2010","journal-title":"Laryngoscope"},{"key":"B11","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1097\/INF.0b013e31828abd13","article-title":"Acute mastoiditis in children: a 10-year retrospective and validated multicenter study","volume":"32","author":"Anthonsen","year":"2013","journal-title":"Pediatr Infect Dis J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1016\/j.ijporl.2007.02.014","article-title":"Acute mastoiditis: increase in the incidence and complications","volume":"71","author":"Benito","year":"2007","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1001\/archoto.2009.75","article-title":"Suppurative complications of acute Otitis media: changes in frequency over time","volume":"135","author":"Thorne","year":"2009","journal-title":"Arch Otolaryngol Neck Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1007\/s00405-019-05606-2","article-title":"Surgical intervention for acute mastoiditis: 10 years experience in a tertiary children hospital","volume":"276","author":"Stern Shavit","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1001\/archotol.134.1.45","article-title":"The relationship between acute mastoiditis and antibiotic use for acute Otitis Media in children","volume":"134","author":"Ho","year":"2008","journal-title":"Arch Otolaryngol Neck Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1097\/INF.0000000000000951","article-title":"Severe acute mastoiditis admission is not related to delayed antibiotic treatment for antecedent acute Otitis media","volume":"35","author":"Grossman","year":"2016","journal-title":"Pediatr Infect Dis J"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39345.405243.BE","article-title":"Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK general practice research database","author":"Petersen","year":"2007","journal-title":"Br Med J."},{"key":"B18","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1097\/QCO.0b013e328338c46d","article-title":"Risk\u2013benefit analysis of restricting antimicrobial prescribing in children: what do we really know?","volume":"23","author":"Keith","year":"2010","journal-title":"Curr Opin Infect Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.ijporl.2019.07.014","article-title":"Acute mastoiditis: 20 years of experience with a uniform management protocol","volume":"125","author":"Mansour","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ijporl.2012.10.003","article-title":"Fusobacterium necrophorum mastoiditis in children \u2013 emerging pathogen in an old disease","volume":"77","author":"Yarden-Bilavsky","year":"2013","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"826","DOI":"10.3389\/fmicb.2020.00826","article-title":"From normal Flora to brain abscesses: a review of Streptococcus intermedius","volume":"11","author":"Issa","year":"2020","journal-title":"Front Microbiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1186\/s40064-015-1608-0","article-title":"Bra\u0131n abscess due to Streptococcus intermedius secondary to mastoiditis in a child","volume":"4","author":"Yakut","year":"2015","journal-title":"SpringerPlus"},{"key":"B23","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s10143-012-0391-4","article-title":"Abrupt clinical onset of chiari type I\/syringomyelia complex: clinical and physiopathological implications","volume":"35","author":"Massimi","year":"2012","journal-title":"Neurosurg Rev"},{"key":"B24","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.nrl.2011.01.008","article-title":"Sleep disturbance: a forgotten syndrome in patients with chiari I malformation","volume":"29","author":"Ferr\u00e9 Mas\u00f3","year":"2014","journal-title":"Neurol Engl Ed"},{"key":"B25","doi-asserted-by":"publisher","first-page":"920","DOI":"10.3171\/jns.2000.92.6.0920","article-title":"Asymptomatic chiari type I malformations identified on magnetic resonance imaging","volume":"92","author":"Meadows","year":"2000","journal-title":"J Neurosurg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"205","DOI":"10.3171\/2011.5.PEDS1121","article-title":"Chiari malformation type I and syrinx in children undergoing magnetic resonance imaging: clinical article","volume":"8","author":"Strahle","year":"2011","journal-title":"J Neurosurg Pediatr"},{"key":"B27","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1007\/BF01708364","article-title":"Sudden death revealing chiari type 1 malformation in two children","volume":"19","author":"Martinot","year":"1993","journal-title":"Intensive Care Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"244","DOI":"10.3171\/2010.11.PEDS1097","article-title":"Patients with chiari malformation type I presenting with acute neurological deficits: case series: clinical article","volume":"7","author":"Yarbrough","year":"2011","journal-title":"J Neurosurg Pediatr"},{"key":"B29","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/PAF.0b013e31817efaf6","article-title":"Sudden death in a 27-year-old man with chiari I malformation","volume":"29","author":"Stephany","year":"2008","journal-title":"Am J Forensic Med Pathol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.1013300\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T15:05:08Z","timestamp":1674486308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.1013300\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":29,"alternative-id":["10.3389\/fped.2022.1013300"],"URL":"https:\/\/doi.org\/10.3389\/fped.2022.1013300","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2023,1,23]]},"article-number":"1013300"}}