Suppurative meningitis due to acute otitis media in adults: report of two cases

Abstract

Two cases of suppurative meningitis due to acute otitis media were reported. Both of the cases were male of more than 50 years old and presented with otalgia and headache. And case 2 also showed otorrhea. In pure-tone audiogram, conductive hearing loss was showed in both cases, while the tympanometry suggested B-type curve in case 1 and As-type curve in case 2. No abnormal was found in case 1 through CT scanning, while otitis media and mastoiditis were showed in case 2 by MR imaging. Both underwent myringotomy and antibiotics therapy. However, otalgia could not been controlled as well as the headache lasted for around 2 weeks. Both cases fell into coma and were diagnosed of suppurative meningitis with the pathogenic bacteria of Streptococcus pneumoniae. Then the patients received the neurological treatment and recovered. We discussed the characteristics of meningitis due to acute otitis media in nowadays. In the occasion of adults with acute otitis media, if the symptoms of otalgia and headache last for over two weeks and can not be released according to the formal treatment, otogenic meningitis should be paid high attention to.