How do meningitis pathogens travel from the middle ear to the meninges?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Local extension from contiguous extracerebral infection (eg, otitis media, mastoiditis, or sinusitis) is a common cause. Possible pathways for the migration of pathogens from the middle ear to the meninges include the following:

  • The bloodstream

  • Preformed tissue planes (eg, posterior fossa)

  • Temporal bone fractures

  • The oval or round window membranes of the labyrinths

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