Luc's abscess: Case report and systematic review of the literature
Absceso de Luc: Presentación de caso y revisión sistemática de la literatura
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Objective: To report a case and review the literature of cases or case series on Luc's abscesses reported until 2024.
Methods: A systematic review of the literature was carried out by two researchers independently following the methodology appropriate to the objectives proposed in this research, which were to describe the case reports or case series on Luc's abscesses. PRISMA guidelines were used to guide the search for relevant documents in electronic databases in the English language in the time period 1938 to 2024 in the PubMed, ScienceDirect, Mendeley and Google Scholar databases with the keywords: ("Luc's abscess" OR "subperiosteal abscess" OR "mastoid abscess") AND ("mastoiditis" OR "mastoid infection" OR "temporal bone").
Results:
Fourteen articles were included, with a total of 17 cases including ours. The mean age was 15.47 years (SD ± 19.35), with three cases in adults and 14 in children, 14 (82.4%) of whom were men. Trismus occurred in 6 cases (35.3%). The mean leukocyte count in 11 of the 17 cases was 18,103 cells/µL (SD ± 5,318). Positive cultures were obtained in 11 cases (67.7%). The isolated microorganisms were mainly Gram-positive bacteria, with Streptococcus being the most common. Surgical treatment was performed in all cases, and a CT scan was performed in 16 of them. One case of cholesteatoma was reported. The country with the highest number of cases reported in the literature was the United States, with 5 (29.4%).
Conclusions:
Luc's abscess is extremely rare in adults after acute otitis media, with children being the most affected age group. Its typical manifestation is acute mastoiditis, with possible involvement of the facial nerve and extension to the parietal, orbito-zygomatic and even occipital regions. CT findings of coalescent mastoiditis may be essential to support the decision to perform a mastoidectomy.
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