Temporal bones were studied in five cases of acute pneumococcal meningitis. All patients had purulent labyrinthitis bilaterally. In addition, two temporal bones from one patient showed a hematogenous spread of the disease. Destruction of the stria vascularis and massive hemorrhage within the cochlear duct were observed. This was probably caused by the vascular affinity of the pneumococci at the time of persistent pneumococcal bacteremia. The findings suggest the existence of primary bacterial endolymphatic involvement, caused by the destruction of labyrinthine vessels.
Igarashi M, Saito R, Alford BR, Filippone MV, Smith JA. Temporal Bone Findings in Pneumococcal Meningitis. Arch Otolaryngol. 1974;99(2):79–83. doi:10.1001/archotol.1974.00780030085001
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