Bacterial meningitis secondary to stapes footplate malformation in a child with an auditory brainstem implant.
OBJECTIVE
We report a rare presentation of otogenic bacterial meningitis secondary to a stapes footplate malformation in a paediatric patient with an auditory brainstem implant.


METHODS
A patient with Mondini's dysplasia developed meningitis six years after auditory brainstem implantation. The aetiology was believed to be otogenic, secondary to stapes footplate malformation.


CONCLUSIONS
To our best knowledge, this is the first report of otogenic bacterial meningitis secondary to stapes footplate malformation in a paediatric patient with an auditory brainstem implant. Subjects with inner ear malformations, especially Mondini's dysplasia, need to be carefully evaluated pre-operatively to reduce or eliminate any anatomical conditions which may predispose to meningitis. In children with an auditory brainstem implant and suspected ear malformation, we recommend pre-operative radiological investigation to look for the 'bulging oval window' sign. When radiological signs are positive, bilateral exploratory tympanotomy should be performed to detect any undiagnosed anatomical stapes footplate defects, which may predispose to bacterial meningitis.
ENT Department, University of Verona, Italy. marcomand@hotmail.com
M
M
Mandalà
L
L
Colletti
D038262:Auditory Brain Stem Implants; D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology; D002648:Child; D004322:Drainage; D007758:Ear, Inner / Q000002:abnormalities* / Q000601:surgery; D005402:Fistula / Q000150:complications*; D006312:Hearing Loss, Bilateral / Q000601:surgery; D006801:Humans; D008297:Male; D008417:Mastoiditis / Q000150:complications* / Q000000981:diagnostic imaging; D008586:Meningitis, Pneumococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000209:etiology*; D010046:Oval Window, Ear / Q000601:surgery; D012307:Risk Factors; D013129:Spinal Puncture; D013199:Stapes / Q000002:abnormalities*; D013201:Stapes Surgery; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000601:surgery