title: Possible role of biofilm in fulminant meningitis related to cochlear implantation of dysplastic inner ear.
abstract: Thanks to improvements in device design and surgical procedures, the number of potential candidates for cochlear implantation has been growing to include patients with inner ear malformations. Many precautions are taken pre-, peri- and postoperatively for these patients given the increased risk of surgical and medical complications, but with the rising bacterial resistance to antibiotics and the discovery of biofilm as a probable cause of chronic infections, postoperative morbidity remains higher than desired.
  
  
  OBJECTIVE
  The purpose of this investigation is to describe histological findings on a temporal bone from a 2-year-old infant with a cochlear implant and an inner ear deformity who died of bacterial meningitis.
  
  
  METHODS
  The patient's temporal bone was studied under light microscopy, the cochlear implant studied with a scanning electron microscope, and later subjected to in situ hybridization to find bacterial DNA.
  
  
  RESULTS
  The scanning electron microscopy image shows cellular formations on the surface of the implant, which later binds to the probe used for the in situ hybridization.
  
  
  CONCLUSIONS
  There is evidence that bacterial DNA is present on the electrode array, which suggests existence of biofilm formation on the cochlear implant surface.
authors.affiliation: House Ear Institute, Department of Histopathology, 2100 West 3rd Street, Los Angeles, CA 90057, USA.
authors.forename: A O
authors.initials: AO
authors.lastname: Makarem
authors.forename: C
authors.initials: C
authors.lastname: Schaudinn
authors.forename: P
authors.initials: P
authors.lastname: Webster
authors.forename: F H
authors.initials: FH
authors.lastname: Linthicum
mesh_terms: D018441:Biofilms; D002675:Child, Preschool; D003054:Cochlear Implants / Q000009:adverse effects*; D007758:Ear, Inner / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008581:Meningitis / Q000209:etiology* / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000209:etiology*