[Diagnosis and management of ENT conditions responsible for acute community acquired bacterial meningitis].
Only few epidemiological studies evaluate the role of ENT infections in meningitis. A retrospective review of data shows that the frequency of ENT infections is estimated at 25% in adults and children. Meningitis may occur during otological and nasosinusal infections. Acute otitis media and mastoiditis are the most common ear infections responsible for meningitis. Chronic otitis (cholesteatoma) are rarely involved. In case of acute rhinosinusitis, frequently responsible frontal and ethmoidal locations are investigated by nasal endoscopy and CT scan. A CSF leak originating mostly from anterior skull base or middle ear, either posttraumatic or spontaneous, may also be associated with meningitis. The management of ENT infections begins with antibiotics. Drainage may be discussed when identification of the bacteria is needed or if the medical treatment seems inefficient. In case of a CSF leak, closure of the defect is performed according to its location and size after evaluation by imaging (CT scan, MRI).
Service ORL, hôpital Jean-Bernard, CHU de Poitiers, 350, avenue Jacques-Coeur, 86000 Poitiers, France. j.m.klossek@chu-poitiers.fr
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Klossek
D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000150:complications / Q000175:diagnosis; D002648:Child; D017714:Community-Acquired Infections / Q000209:etiology*; D004322:Drainage; D006801:Humans; D008279:Magnetic Resonance Imaging; D008417:Mastoiditis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016920:Meningitis, Bacterial / Q000209:etiology*; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010038:Otorhinolaryngologic Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis; D013353:Subdural Effusion / Q000150:complications / Q000175:diagnosis; D014057:Tomography, X-Ray Computed