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Martine Muffat-Joly; Béatrix Barry, MD; Dominique Hénin, MD; Michel Fay; Pierre Gehanno, MD; Jean-Jacques Pocidalo, MD

Arch Otolaryngol Head Neck Surg. 1994;120(9):925-930.

Abstract
Objective
Study and development of a gerbil model of pneumococcal meningoencephalitis secondary to acute middle ear (ME) otitis. Preliminary data raised the hypothesis of a direct bacterial dissemination from the ME focus to the central nervous system. This infection pattern was examined.

Design
Animals were inoculated bilaterally by transbulla challenge with a serotype 3 strain of Streptococcus pneumoniae at various inoculum sizes. The incidence and course of meningeal complications were studied in relation to the course of ME otitis.

Results
After inoculation of 40 bacteria per ear, lethal meningeal complications occurred in 14 (29%) of 48 cases. A 76% rate (25 of 33 animals) of early meningeal involvement was observed after inoculation of 10⁴ bacteria per ear. Actual involvement of brain was confirmed histologically for both infection schemes. Bacterial counts 20 to 22 hours after infection with the higher inoculum showed various phases of the extension of the ME infection to brain tissue, cerebrospinal fluid, and bloodstream. Bacterial counts in ME and brain tissue were strongly correlated (P<.001). Nine of the 25 animals with infection of the central nervous system had positive brain tissue cultures without bacteremia.

Conclusion
Gradations in inflammatory aspects of the meninges and cerebral parenchyma, together with bacteriologic findings, indicate a primary invasion of meningeal spaces that can result in lethal encephalitis and septicemia. This model might be useful for preclinical therapeutic assays on pneumococcal meningeal complications, including infections due to strains with abnormal susceptibility to antibiotics.

(Arch Otolaryngol Head Neck Surg. 1994;120:925-930)

Author Affiliations
From the National Institute of Health and Medical Research (INSERM), Unit 13, Paris, France (Ms Muffat-Joly, Drs Barry and Pocidalo, and Mr Fay); Department of Otolaryngology, Bichat-Claude Bernard Hospital, Paris (Drs Barry and Gehanno); and Department of Pathology, Beaujon Hospital, Clichy, France (Dr Hénin).

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