A 3 year old child is brought to the emergency room by her concerned parents. They state the girl has been complaining of a severe headache and has had two episodes of vomiting. On physical examination, there is bilateral papilledema and an impaired level of consciousness. Emergency contrast CT scan demonstrates displacement of the ventricular system by a multilocular "mass" with well-defined white high-attenuation rings around black low-attenuation centers. The lesion involves the cerebellum. To which of the following conditions is this lesion most likely related?
The child has a cerebellar abscess. Abscess of the brain can be caused by any of the choices listed, but about 60% are related to middle ear infection. Cerebellar abscess is specifically associated with middle ear infection. Bacteremia following tooth extraction and blood borne bacteria from lung abscess are relatively uncommon causes of intracranial abscess. Subdural empyema in infants is usually a complication of bacterial meningitis.
Bacteremia following tooth extraction
Bacterial meningitis
Lung abscess
Otitis media