XXIII Otitic Meningitis in the Antibiotic Era

Abstract

Persistency of otogenic meningitis in this antibiotic era is a definite challange to the practicing otologist. Inadequacy of chemo therapy, masking of symptoms, and development of drug resistant strains of organisms have been cited as the chief cause of this serious complication. 1 The purpose of this paper is to call attention to the fact that what appears to be a simple middle ear infection, acute or chronic, may lead to a grave intracranial disorder. The practicing otologist must recognize his responsibility in the reduction of morbid ity and mortality from this source. In the light of recent advances in the field of chemotherapy and surgery of the temporal bone, the otologist of the present generation should be able to render services hitherto unknown in the annals of medical history. 3 During a period of eight years from 1950-1957, 66 cases of otitic meningitis in all ages, races and sexes were observed. Thirtyeight of these were children under 15 years of age. Twenty survived and eighteen died, presenting a mortality rate of 47 per cent. The details of a study of these cases will appear in another paper." Of the 28 adults twelve died in the institution. This is a mortality rate of 43 per cent. In the present study the discussion is limited to otogenous meningitis among adult patients. The youngest was 16 and the oldest was 70 years old. All races were represented with a pre ponderance of Caucasians, corresponding to the racial distribution of the general public in this area. Thus there is no evidence of racial immunity