{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:04:02Z","timestamp":1770059042180,"version":"3.49.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007797","name":"University of Helsinki","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007797","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Otogenic meningitis is a rare but potentially life-threatening intracranial complication of otitis media (OM). Our aim was to study the incidence of childhood otogenic meningitis and to compare clinical presentation, causative pathogens, diagnostics, treatment, and outcome of otogenic versus non-otogenic meningitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Charts were reviewed for 47 children admitted to our tertiary center with bacterial meningitis (BM) between 2010 and 2020. Otoscopy and\/or imaging were used to determine the otogenic meningitis ratio and the mean annual incidence was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight (17%) of the 47 BM cases were otogenic [5 males; median age 1.3 years (range 2 months to 16 years)]. The otogenic meningitis incidence was 0.3\/100 000\/year. The classic triad of fever, altered level of consciousness, and meningeal irritation was more common in children with otogenic meningitis (50%, 4\/8) than without OM (14%, 5\/36) (\n                      <jats:italic>P\u2009=\u20090.042<\/jats:italic>\n                      ).\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      was a more common pathogen in children with OM (88%, 7\/8) than without OM (14%, 4\/29) (\n                      <jats:italic>P\u2009&lt;\u20090.001<\/jats:italic>\n                      ), whereas\n                      <jats:italic>Neisseria meningitidis<\/jats:italic>\n                      infection occurred only in children without OM (41%, 12\/29) (\n                      <jats:italic>P\u2009=\u20090.036<\/jats:italic>\n                      ). Neurological sequelae at discharge were present in 3 (38%) children with OM. Deafness was diagnosed in two children, both with otogenic backgrounds. Three children showed long-term sequelae: 2 had deafness (aged\u2009&lt;\u20092 years) and 1 had aphasia\/dysphasia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The incidence of otogenic meningitis was 0.3\/100 000\/year, with\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      the most common causative pathogen. Deafness was the most common long-term sequela and occurred only in children with otogenic meningitis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-025-02690-x","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T12:10:59Z","timestamp":1763381459000},"page":"433-442","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Otogenic meningitis in children"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8568-1997","authenticated-orcid":false,"given":"Laura","family":"Lempinen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2622-585X","authenticated-orcid":false,"given":"Riste","family":"Saat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-6944","authenticated-orcid":false,"given":"Anu","family":"Laulajainen-Hongisto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-8532","authenticated-orcid":false,"given":"Antti A.","family":"Aarnisalo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-4567","authenticated-orcid":false,"given":"Tea","family":"Nieminen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1945-4008","authenticated-orcid":false,"given":"Jussi","family":"Jero","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"issue":"3","key":"2690_CR1","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/S1473-3099(10)70012-8","volume":"10","author":"A Vergison","year":"2010","unstructured":"Vergison A, Dagan R, Arguedas A, et al. Otitis media and its consequences: beyond the earache. LancetInfectious Dis. 2010;10(3):195\u2013203. https:\/\/doi.org\/10.1016\/S1473-3099(10)70012-8","journal-title":"LancetInfectious Dis"},{"key":"2690_CR2","doi-asserted-by":"publisher","unstructured":"Bjar N, Hermansson A, Gisselsson-Solen M. How common is otogenic meningitis? A retrospective study in Southern Sweden over 18 years. Infection. Published online February 28, 2024. https:\/\/doi.org\/10.1007\/s15010-024-02195-z.","DOI":"10.1007\/s15010-024-02195-z"},{"issue":"1","key":"2690_CR3","first-page":"104","volume":"16","author":"J Kangsanarak","year":"1995","unstructured":"Kangsanarak J, Navacharoen N, Fooanant S, Ruckphaopunt K. Intracranial complications of suppurative otitis media: 13 years\u2019 experience. Am J Otol. 1995;16(1):104\u20139.","journal-title":"Am J Otol"},{"key":"2690_CR4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/1471-2334-5-93","volume":"5","author":"C Ostergaard","year":"2005","unstructured":"Ostergaard C, Konradsen HB, Samuelsson S. Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection. BMC Infect Dis. 2005;5:93. doi:1471-2334-5-93 [pii].","journal-title":"BMC Infect Dis"},{"issue":"5","key":"2690_CR5","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1111\/j.1469-0691.2009.02841.x","volume":"16","author":"TI Pedersen","year":"2010","unstructured":"Pedersen TI, Howitz M, Ostergaard C. Clinical characteristics of haemophilus influenzae meningitis in Denmark in the post-vaccination era. Clin Microbiol Infect. 2010;16(5):439\u201346. https:\/\/doi.org\/10.1111\/j.1469-0691.2009.02841.x","journal-title":"Clin Microbiol Infect"},{"key":"2690_CR6","doi-asserted-by":"publisher","unstructured":"Lempinen L, Karppinen M, Pelkonen T, et al. Otitis media-associated bacterial meningitis in children in a low-income country. Pediatr Infect Dis J. Published online June 17, 2019. https:\/\/doi.org\/10.1097\/INF.0000000000002335","DOI":"10.1097\/INF.0000000000002335"},{"issue":"3","key":"2690_CR7","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1097\/00005537-199903000-00026","volume":"109","author":"B Barry","year":"1999","unstructured":"Barry B, Delattre J, Vie F, Bedos JP, Gehanno P. Otogenic intracranial infections in adults. Laryngoscope. 1999;109(3):483\u20137.","journal-title":"Laryngoscope"},{"key":"2690_CR8","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1055\/s-0039-1697995","volume":"24","author":"T Marom","year":"2020","unstructured":"Marom T, Shemesh S, Habashi N, Gluck O, Tamir SO. Adult otogenic meningitis in the pneumococcal conjugated vaccines era. Int Arch Otorhinolaryngol. 2020;24:175\u201381. https:\/\/doi.org\/10.1055\/s-0039-1697995.","journal-title":"Int Arch Otorhinolaryngol"},{"issue":"2","key":"2690_CR9","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/apa.14942","volume":"109","author":"MB Svendsen","year":"2020","unstructured":"Svendsen MB, Ring Kofoed I, Nielsen H, Sch\u00f8nheyder HC, Bodilsen J. Neurological sequelae remain frequent after bacterial meningitis in children. Acta Paediatr. 2020;109(2):361\u20137. https:\/\/doi.org\/10.1111\/apa.14942.","journal-title":"Acta Paediatr"},{"issue":"5","key":"2690_CR10","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/S1473-3099(10)70048-7","volume":"10","author":"K Edmond","year":"2010","unstructured":"Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. LancetInfectious Dis. 2010;10(5):317\u201328. https:\/\/doi.org\/10.1016\/S1473-3099(10)70048-7","journal-title":"LancetInfectious Dis"},{"issue":"1","key":"2690_CR11","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/INF.0b013e3181ef25f7","volume":"30","author":"A Chandran","year":"2011","unstructured":"Chandran A, Herbert H, Misurski D, Santosham M. Long-term sequelae of childhood bacterial meningitis. Pediatr Infect Disease J. 2011;30(1):3\u20136. https:\/\/doi.org\/10.1097\/INF.0b013e3181ef25f7.","journal-title":"Pediatr Infect Disease J"},{"issue":"3\u20134","key":"2690_CR12","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1080\/00016489.2022.2058708","volume":"142","author":"F Persson","year":"2022","unstructured":"Persson F, Bjar N, Hermansson A, Gisselsson-Solen M. Hearing loss after bacterial meningitis, a retrospective study. Acta Otolaryngol. 2022;142(3\u20134):298\u2013301. https:\/\/doi.org\/10.1080\/00016489.2022.2058708.","journal-title":"Acta Otolaryngol"},{"issue":"3","key":"2690_CR13","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.jinf.2005.05.012","volume":"52","author":"M KLEEMOLA","year":"2006","unstructured":"Kleemola M, Noksokoivisto J. Is there any specific association between respiratory viruses and bacteria in acute otitis media of young children? J Infect. 2006;52(3):181\u20137. https:\/\/doi.org\/10.1016\/j.jinf.2005.05.012.","journal-title":"J Infect"},{"issue":"18","key":"2690_CR14","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1056\/NEJMoa040845","volume":"351","author":"D van de Beek","year":"2004","unstructured":"van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351(18):1849\u201359. https:\/\/doi.org\/10.1056\/NEJMoa040845.","journal-title":"N Engl J Med"},{"issue":"12","key":"2690_CR15","doi-asserted-by":"publisher","first-page":"5203","DOI":"10.1007\/s00431-024-05788-w","volume":"183","author":"L Lempinen","year":"2024","unstructured":"Lempinen L, Saat R, Niemel\u00e4 S, et al. Neurological sequelae after childhood bacterial meningitis. Eur J Pediatr. 2024;183(12):5203\u201312. https:\/\/doi.org\/10.1007\/s00431-024-05788-w.","journal-title":"Eur J Pediatr"},{"issue":"2","key":"2690_CR16","doi-asserted-by":"publisher","first-page":"361","DOI":"10.3174\/ajnr.A4120","volume":"36","author":"R Saat","year":"2015","unstructured":"Saat R, Laulajainen-Hongisto AH, Mahmood G, et al. MR imaging features of acute mastoiditis and their clinical relevance. Am J Neuroradiol. 2015;36(2):361\u20137. https:\/\/doi.org\/10.3174\/ajnr.A4120.","journal-title":"Am J Neuroradiol"},{"issue":"8","key":"2690_CR17","doi-asserted-by":"publisher","first-page":"2632","DOI":"10.1007\/s00330-015-4113-5","volume":"26","author":"R Saat","year":"2016","unstructured":"Saat R, Mahmood G, Laulajainen-Hongisto A, et al. Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images. Eur Radiol. 2016;26(8):2632\u20139. https:\/\/doi.org\/10.1007\/s00330-015-4113-5.","journal-title":"Eur Radiol"},{"issue":"7968","key":"2690_CR18","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1016\/S0140-6736(76)92215-7","volume":"307","author":"B Jennett","year":"1976","unstructured":"Jennett B, Teasdale G, Braakman R, Minderhoud J, Knill-Jones R. Predicting outcome in individual patients after severe head injury. Lancet. 1976;307(7968):1031\u20134. https:\/\/doi.org\/10.1016\/S0140-6736(76)92215-7.","journal-title":"Lancet"},{"issue":"7","key":"2690_CR19","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1097\/00006454-200207000-00013","volume":"21","author":"D TURNER","year":"2002","unstructured":"TURNER D, LEIBOVITZ E. Acute otitis media in infants younger than two months of age: microbiology, clinical presentation and therapeutic approach. Pediatr Infect Dis J. 2002;21(7):669\u201374. https:\/\/doi.org\/10.1097\/00006454-200207000-00013.","journal-title":"Pediatr Infect Dis J"},{"key":"2690_CR20","unstructured":"Kotikoski MJ, Palmu AAI, Puhakka HJ. The Symptoms and Clinical Course of Acute Bullous Myringitis in Children Less than Two Years of Age. www.elsevier.com\/locate\/ijporl"},{"issue":"11","key":"2690_CR21","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1017\/S0022215110000976","volume":"124","author":"SI Ibrahim","year":"2010","unstructured":"Ibrahim SI, Cheang PP, Nunez DA. Incidence of meningitis secondary to suppurative otitis media in adults. J Laryngol Otol. 2010;124(11):1158\u201361. https:\/\/doi.org\/10.1017\/S0022215110000976.","journal-title":"J Laryngol Otol"},{"issue":"4","key":"2690_CR22","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1542\/peds.2006-2138","volume":"119","author":"KA Poehling","year":"2007","unstructured":"Poehling KA, Szilagyi PG, Grijalva CG, et al. Reduction of frequent otitis media and pressure-equalizing tube insertions in children after introduction of pneumococcal conjugate vaccine. Pediatrics. 2007;119(4):707\u201315. https:\/\/doi.org\/10.1542\/peds.2006-2138.","journal-title":"Pediatrics"},{"issue":"9862","key":"2690_CR23","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/S0140-6736(12)61854-6","volume":"381","author":"AA Palmu","year":"2013","unstructured":"Palmu AA, Jokinen J, Borys D, et al. Effectiveness of the ten-valent pneumococcal haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against invasive pneumococcal disease: a cluster randomised trial. Lancet. 2013;381(9862):214\u201322. https:\/\/doi.org\/10.1016\/S0140-6736(12)61854-6.","journal-title":"Lancet"},{"issue":"9","key":"2690_CR24","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1111\/j.1469-0691.2011.03668.x","volume":"18","author":"SGB Heckenberg","year":"2012","unstructured":"Heckenberg SGB, Brouwer MC, van der Ende A, Hensen EF, van de Beek D. Hearing loss in adults surviving pneumococcal meningitis is associated with otitis and pneumococcal serotype. Clin Microbiol Infect. 2012;18(9):849\u201355. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03668.x.","journal-title":"Clin Microbiol Infect"},{"issue":"5","key":"2690_CR25","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1177\/0194599817699599","volume":"156","author":"KO Tawfik","year":"2017","unstructured":"Tawfik KO, Ishman SL, Altaye M, Meinzen-Derr J, Choo DI. Pediatric acute otitis media in the era of pneumococcal vaccination. Otolaryngology\u2013Head Neck Surg. 2017;156(5):938\u201345. https:\/\/doi.org\/10.1177\/0194599817699599.","journal-title":"Otolaryngology\u2013Head Neck Surg"},{"issue":"3","key":"2690_CR26","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/j.pcl.2005.02.011","volume":"52","author":"S Chavez-Bueno","year":"2005","unstructured":"Chavez-Bueno S, McCracken GH Jr. Bacterial meningitis in children. Pediatr Clin North Am. 2005;52(3):795\u2013810. vii. doi:S0031-3955(05)00038-6 [pii].","journal-title":"Pediatr Clin North Am"},{"issue":"6","key":"2690_CR27","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1097\/00129492-200311000-00015","volume":"24","author":"MB Wellman","year":"2003","unstructured":"Wellman MB, Sommer DD, McKenna J. Sensorineural hearing loss in postmeningitic children. Otol Neurotol. 2003;24(6):907\u201312.","journal-title":"Otol Neurotol"},{"issue":"5","key":"2690_CR28","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1097\/00006454-199305000-00008","volume":"12","author":"LJ Baraff","year":"1993","unstructured":"Baraff LJ, Lee SI, Schriger DL. Outcomes of bacterial meningitis in children: a meta-analysis. Pediatr Infect Dis J. 1993;12(5):389\u201394.","journal-title":"Pediatr Infect Dis J"},{"issue":"9","key":"2690_CR29","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1136\/adc.67.9.1128","volume":"67","author":"HM Fortnum","year":"1992","unstructured":"Fortnum HM. Hearing impairment after bacterial meningitis: a review. Arch Dis Child. 1992;67(9):1128\u201333. https:\/\/doi.org\/10.1136\/adc.67.9.1128.","journal-title":"Arch Dis Child"},{"issue":"14","key":"2690_CR30","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1056\/NEJM198410043111401","volume":"311","author":"PR Dodge","year":"1984","unstructured":"Dodge PR, Davis H, Feigin RD, et al. Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis. N Engl J Med. 1984;311(14):869\u201374. https:\/\/doi.org\/10.1056\/NEJM198410043111401","journal-title":"N Engl J Med"},{"issue":"9","key":"2690_CR31","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1017\/S0022215107006032","volume":"121","author":"Y Slovik","year":"2007","unstructured":"Slovik Y, Kraus M, Leiberman A, Kaplan DM. Role of surgery in the management of otogenic meningitis. J Laryngol Otol. 2007;121(9):897\u2013901. https:\/\/doi.org\/10.1017\/S0022215107006032.","journal-title":"J Laryngol Otol"},{"issue":"29","key":"2690_CR32","doi-asserted-by":"publisher","first-page":"7740","DOI":"10.1523\/JNEUROSCI.0554-16.2016","volume":"36","author":"M Perny","year":"2016","unstructured":"Perny M, Roccio M, Grandgirard D, Solyga M, Senn P, Leib SL. The severity of infection determines the localization of damage and extent of sensorineural hearing loss in experimental pneumococcal meningitis. J Neurosci. 2016;36(29):7740\u20139. https:\/\/doi.org\/10.1523\/JNEUROSCI.0554-16.2016.","journal-title":"J Neurosci"},{"issue":"6","key":"2690_CR33","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1007\/s15010-007-7035-6","volume":"35","author":"LC Santos","year":"2007","unstructured":"Santos LC, Sim\u00f5es J, Severo M, Vazquez J, Lecour H. Bacterial meningitis in an urban area: etiologic study and prognostic factors. Infection. 2007;35(6):406\u201313. https:\/\/doi.org\/10.1007\/s15010-007-7035-6.","journal-title":"Infection"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02690-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-025-02690-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02690-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T08:39:41Z","timestamp":1770021581000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-025-02690-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["2690"],"URL":"https:\/\/doi.org\/10.1007\/s15010-025-02690-x","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"assertion":[{"value":"8 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}