Otitic meningitis, an infection of the cerebrospinal fluid system, is comparable to otitic sepsis, an infection of the blood stream. Nature attempts in both conditions to localize the infection by erecting protective barriers which tend to limit the bacteria to the area of initial involvement. Finally, when nature unaided is insufficient to prevent a general invasion, the bacteria circulate freely in the blood stream or in the cerebrospinal fluid system. This results in general sepsis, with a noticeable reduction in the number of recoveries, or in suppurative meningitis, with few recoveries. Here the end result widens the comparison tremendously and gives significance to the need of adopting toward otitic suppurative meningitis a definite surgical attitude, similar in principle to that generally taken toward otitic sepsis.
Formerly, when meningitis occurred during otitic infection, there was often undue delay before the primary focus was eliminated. Now the mastoid infection is exenterated as
SACKS P. HEMOLYTIC STREPTOCOCCUS MENINGITIS OF OTITIC ORIGINREPORT OF A RECOVERY. Arch Otolaryngol. 1938;28(3):364–370. doi:10.1001/archotol.1938.00650040373005