title: [Pneumococcal meningitis revealing dysplasia of the bony labyrinth in an infant].
abstract: BACKGROUND
  Dysplasias of the bony labyrinth are frequently associated with cerebrospinal fluid fistula and are usually discovered because of recurrent meningitis.
  
  
  METHODS
  A 1 year-old infant was admitted for a pneumococcal meningitis which appeared 2 days after the occurrence of a clear otorrhea from the right ear. The same organism was isolated from the otorrhea fluid, which also contained cerebrospinal fluid as confirmed cytochemically. The meningitis rapidly resolved with antibiotic treatment. Auditory brain stem responses were abolished from the right ear. CT of the temporal bones showed a pseudo-Mondini type labyrinth dysplasia at the right ear and Mondini type dysplasia at the left one. A translabyrinthine cerebrospinal fluid fistula was discovered by surgical exploration of the right ear, occurring through a perforation in the stapedial foot plate. The leak was cured by packing the vestibule and obturating both oval and round windows. Three years after the operation, the child did not experience any further episode of otorrhea or meningitis.
  
  
  CONCLUSIONS
  Features suggesting a translabyrinthine fistula, especially otorrhea and deafness, should be systematically searched in any child with bacterial meningitis. Closure of these fistulas can prevent severe infectious recurrences.
authors.affiliation: Service de pédiatrie, hôpital Jean-Verdier, Bondy, France.
authors.forename: D
authors.initials: D
authors.lastname: Louaib
authors.forename: M
authors.initials: M
authors.lastname: François
authors.forename: E
authors.initials: E
authors.lastname: Coderc
authors.forename: S
authors.initials: S
authors.lastname: Dieu
authors.forename: M
authors.initials: M
authors.lastname: Nathanson
authors.forename: P
authors.initials: P
authors.lastname: Narcy
authors.forename: J
authors.initials: J
authors.lastname: Gaudelus
mesh_terms: D002558:Cerebrospinal Fluid Otorrhea / Q000151:congenital / Q000209:etiology; D007758:Ear, Inner / Q000002:abnormalities*; D005260:Female; D005402:Fistula / Q000150:complications* / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007223:Infant; D007759:Labyrinth Diseases / Q000150:complications* / Q000151:congenital / Q000175:diagnosis / Q000601:surgery; D008586:Meningitis, Pneumococcal / Q000209:etiology*
vernacular_title: Méningite à pneumocoque révélatrice d'une dysplasie du labyrinthe osseux chez un nourrisson.