2017 Volume 151 Pages 14-15
We report the case of 39-year-old female patient who was diagnosed as having bacterial meningitis (BM) complicating acute otitis media. The patient presented with 5-day history of acute otitis media and a 4-day history of headache, vomiting, and high fever. We diagnosed her as having BM based on clinical evidence of meningeal involvement and the result of a cerebrospinal fluid analysis. The patient was started on intravenous prednisolone and meropenem for empiric treatment of both the BM and sensorineural hearing loss. These treatments led to rapid relief of the patient’s symptoms without any sequela. Temporal-bone CT showed the suggestion of a partial bone defect in the temporal tegmen. Exploratory tympanotomy of the right ear confirmed the presence of the bone defect in the temporal tegmen and the attic was obliterated with a bone plate.
BM is considered as a neurological emergency. The possibility of BM should be borne in mind in patients with otitis media presenting with persistent meningeal symptoms.
