We report the case of a 44-year-old woman, suffering from lethal cerebritis of the temporal lobe caused by an unusual chronic otitis media with granulations. A chronic inflammatory process of the left temporal bone had affected the patient over a period of 4 years. This had started with mastoiditis accompanied by a lesion of the dura mater, leading to labyrinthitis, encephalitis and cerebellar abscess. The patient's symptoms persisted, especially vertigo and uncertainty, and then deteriorated acutely. MRI showed otogenic cerebritis. Intracranial bleeding from vasculitis had worsened the patient's condition, finally resulting in the patient's death. This case impressively demonstrates that a cerebral abscess can cause acute worsening of general complaints associated with ear disease and results in a fatal outcome at any stage.