Diagnosis and management of ENT conditions responsible for acute community acquired bacterial meningitis

作者：Klossek J M^*

来源：Medecine et Maladies Infectieuses, 2009, 39(7-8): 554-559.

DOI：10.1016/j.medmal.2009.02.027

• Rhinosinusitis
• Otitis
• Bacterial meningitis
• Pneumococcus

Only few epidemiological studies evaluate the role of ENT infections in meningitis. A retrospective review of data shows that the frequency of ENT infections is estimated at 25% in adults and children. Meningitis may occur during otological and nasosinusal infections. Acute otitis media and mastoiditis are the most common ear infections responsible for meningitis. Chronic otitis (cholesteatoma) are rarely involved. In case of acute rhinosinusitis, frequently responsible frontal and ethmoidal locations are investigated by nasal endoscopy and CT scan. A CSF leak originating mostly from anterior skull base or middle car, either posttraumatic or spontaneous, may also be associated with meningitis. The management of ENT infections begins with antibiotics. Drainage may be discussed when identification of the bacteria is needed or if the medical treatment seems inefficient. In case of a CSF leak, closure of the defect is performed according to its location and size after evaluation by imaging (CT scan, MRI).

• 出版日期2009-8