流行性脳脊髓膜炎を先行せる耳性化膿性脳膜炎

　1．緒言

　最初耳性腦膜炎を疑はしめ腰椎穿刺の結果流行性腦脊髓膜炎と決定し，治療中更にS状洞血栓，同周囲膿瘍となり，再轉して耳性化膿性脳膜炎に移行し，S状洞開放，ペニシリン療法，腰椎弓切除術等あらゆる治療も効なく，遂に死の轉帰をとつた比較的興味ある症例を経驗したので，報告する．

Kono reports a case of cerebral meninitis of otitic origin, the pathology of which is found in concurrent existence with latent epidemic cere-bro-spinal meningitis. A boy 13 years of age developed symptoms which were diagnosed as cerebral meningi tis presumably caused from his chronic cholesteatomatous otitis media which he had harbored and suffered for a considrable period of time. Laboratory examination of the spinal fluid revealed and established the present staus as that of epidemic cerebrospinal mening-itis. While the patient was being treated for the latter disease symptoms pointing to throm-bosis of sigmoid sinus were manifested. Thro-mbosis og the sigmoid sinus as well as abcess in suructures about it and on the adjoining dura were found at the time of the operation.

Adequate drainage of the sigmoid sinus was established; penicillin treatments given; and, spinal laminectomies of lumbar vertebrae were performed, but, despite all efforts the treatme-nts proved inegective towards remission of the disease and the patient died.