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OTITICMENINGITIS. Presented by DR. E. B. GLEASON.
Prompt myringotomy and early mastoid operation, if necessary, are the best measures of avoiding otitic meningitis. Many patients with acute otitis media showing cervical rigidity and other symptoms of meningitis promptly recover when these operations are speedily performed. In cases in which the patients do not so respond but develop a true meningitic process, the disease begins as an osteomyelitis with infection of the meninges as soon as, or before, the aural mucosa. Most all fatal cases of aural intracranial complications terminate as septic leptomeningitis.
Two clinical varieties of leptomeningitis can be differentiated. The serous or protective type and the purulent or infective. The finding of bacteria in the spinal fluid establishes the diagnosis of the latter variety. The treatment for the serous type is rest in bed, the use of an ice cap, and the diminution of intracranial pressure by purgation