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緒言
電撃性耳性化膿性脳膜炎は非常に稀有な疾患であり,文献によれば其の殆んどは死亡して居る.最近私は発病後43時間で化膿性脳膜炎を起し,50時間目に錐体手術を行い,且種々の化学療法を行い術後2ケ月半で完全治癒した本症例を経験したので茲に報告し諸先生方の御批判を仰ぐ次第である.
YOSHIO reports a case of meningitis otitic in origin which began with a fulminating onset.The patient was successfully cured by operation on the petrous pyramid which was followed by instilla-tion of penicillin in the tourth ventricle, intramu-scular injections of penicillin- streptomycin and administration of "salsol" by mouth. The outstan-ding pathological changes noted in microscopic exa-mination of tissues removed at the time of operation were hemorrhagic in nature. Vessels within the bony canaliculae appeared to be highly engorged with erythrocytes and some of which to be clogged with thrombosis. There were areas of bone which sho-wed necrotic changes presumably due to lack of pro-per circulation. in operative technic the author followed a method by which cells of petrous pyra-mid were exenterated without the necessity of reso-rting to section of semicircular canals. The author emphasizes that, in meningitis cf this nature, rather than attempting to open internal aural canal for drainage instillation of penicillin into the fourth ventricle proved to be much more effective towards the cure. In these days when biochemical therapy is much in use cultures from aural discharges as well as spinal fluid may show floras resistant to penicillin. In such cases either streptomycin and/or sulfa drugs should be used.
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