title: Role of surgery in the management of otogenic meningitis.
abstract: Meningitis is a life-threatening complication of otitis media. The appropriate management and the role of surgical intervention are still controversial, and there are no evidence-based guidelines in this regard. We report three cases of otogenic meningitis, initially treated with parenteral antibiotics and myringotomy, followed by surgery. Two patients had an emergency mastoidectomy and one patient underwent surgery one month post-recovery due to the suspicion of bone erosion on a computed tomography scan. In two cases, a canal wall up procedure was performed, and one patient underwent revision of a radical mastoidectomy. In all cases, no pus or granulations were seen in the mastoid. Two patients fully recovered and one patient died. We review the literature and critically discuss the role, timing and preferred type of surgery for otogenic meningitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center, Beer Sheva, Israel. youvals@bgumail.bgu.ac.il
authors.forename: Y
authors.initials: Y
authors.lastname: Slovik
authors.forename: M
authors.initials: M
authors.lastname: Kraus
authors.forename: A
authors.initials: A
authors.lastname: Leiberman
authors.forename: D M
authors.initials: DM
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000628:therapy; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications* / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents