Rapid evolution of acute mastoiditis : three case reports of otogenic meningitis in adults

Otogenic meningitis is the most common intracranial complication of neglected otitis media. In the western world, such complications seldom occur in children and young adults and are extremely rare in adults and elderly people. The current use of antibiotics and of more sophisticated surgery has greatly diminished the incidence of otogenic meningitis in comparison with the past. This has resulted in physicians having less experience concerning diagnosis and treatment of this complication. The authors reported 3 consecutive cases of otogenic meningitis in adults, which occurred in the space of 3 months after a 6-year absence of such pathology at their institution. In all 3 cases, conventional antibiotic therapy proved ineffective; the course of the disease worsened rapidly in contrast with the lack of symptoms during the period before treatment. Emergency surgical treatment was mandatory.