Article in Japanese

A case of congenital inner ear anomaly with bacterial meningitis

Yukimi OYOSHI¹⁾, TAE OMORI¹⁾, Yuki KASUGA¹⁾, Hisamitsu TAMAKI¹⁾, Masahiro ITO¹⁾, Masahiro MISAWA¹⁾

This study reports the case of an 11-years-old girl with profound deafness, due to congenital inner ear anomaly. She had been admitted to hospital twice before because of aseptic meningitis. One day, she felt an uncomfortable feeling in her left ear and went to hospital. She received a diagnosis of acute otitis media and left myringotomy was performed. The next day, she presented headache, vomiting and fever to this emergency department. A blood test showed high inflammation level. The cerebrospinal fluid test showed increased number of cells and protein level. Also, the glucose level of cerebrospinal fluid decreased. Her illness was diagnosed as bacterial meningitis and antimicrobial therapy started. A blood and cerebrospinal fluid culture detected Streptococcus pneumoniae and the serum type was 15C. After a 14-day total term of antimicrobial therapy, the patient was discharged 17 days post hospital admission.
There have been many case reports of recurrent bacterial meningitis with congenital inner ear anomaly. It is said that cerebrospinal fluid otorrhea is the cause of recurrent bacterial meningitis. To prevent recurrent bacterial meningitis, surgical inner ear plombage is performed. The degree of deafness with congenital inner ear anomaly ranges from mild to severe. Therefore, inner ear anomaly should be searched for in bacterial meningitis patients even if they are not deaf.
This patient had not received pneumococcal vaccination, although she had the high risk for meningitis caused by congenital inner ear anomaly. Therefore, it is important to receive a vaccine.

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1) Department of Pediatrics, Tokyo Metropolitan Bokutoh Hospital

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Received	September 20, 2016
Accepted	April 21, 2017

29 (2)：153─159,2017