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Management of Otogenic Meningitis: A Proposal for Practical Guidelines from a Multicenter Experience with a

Alessia Rubini1, Guglielmo Ronzani2, Edoardo D'Alessandro1

  • 1Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Modena, 41125 Modena, Italy.

Journal of Clinical Medicine
|September 28, 2024
PubMed

Insights

Otogenic meningitis, a severe complication of middle ear infections, requires prompt antibiotic treatment. Surgery is indicated for complications or when antibiotics fail, aiming to clear infection from the ear and mastoid areas.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Neurosurgery

Background:

  • Otogenic meningitis is a frequent and severe complication of middle ear infections.
  • Optimal management strategies and the role of surgery remain undefined.
  • This study addresses the need for clear clinical guidelines.

Purpose of the Study:

  • To investigate the management of otogenic meningitis.
  • To define the role and timing of surgical intervention.
  • To establish a decision-making framework for treatment.

Main Methods:

  • A six-year multicenter retrospective study of patients with otogenic meningitis.
  • Systematic review of literature on acute otitis media-related meningitis (PRISMA 2020).
  • Analysis of 16 patients and 181 patients from 24 studies.

Main Results:

  • 13 of 16 patients (81%) underwent surgery within 7 days.
  • Surgery is employed for complications or treatment failure within 48 hours.
  • Systematic review included 24 studies from 1990-2023.

Conclusions:

  • Antibiotics are the primary treatment for bacterial meningitis.
  • Surgery is crucial for managing complications and persistent infections.
  • Surgical goals include eradicating infection and managing intracranial complications.

Keywords:
acute otitis mediainfective middle ear diseaseintracranial complications of otitis mediamastoidectomymeningitistemporal bone

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