What is it about?
An elderly man with diabetes developed bacterial meningoencephalitis caused by a hidden mastoid infection (“masked mastoiditis”) that showed no typical ear symptoms. Imaging was key to diagnosis, and cultures revealed Streptococcus pneumoniae.
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Why is it important?
Masked mastoiditis is rare but dangerous, especially in older and diabetic patients. It often lacks clear clinical signs, delaying diagnosis. Such hidden infections carry a high risk of life-threatening intracranial complications like meningitis. Highlights the need for vaccination (pneumococcal) and vigilance in diabetic elderly patients.
Perspectives
Clinicians should always consider ear and sinus origins in unexplained meningitis cases in older adults. Imaging (CT/MRI) is essential when symptoms are atypical. Preventive strategies—better antibiotic use, vaccination, and early ENT evaluation—are crucial. This case underlines how age, diabetes, and immune decline increase vulnerability to uncommon but severe infections.
Prof Takuya Omura
National Center for Geriatrics and Gerontology
Read the Original
This page is a summary of: Meningoencephalitis caused by masked mastoiditis that was diagnosed during a follow‐up in an elderly patient with diabetes mellitus: A case report, Geriatrics and Gerontology International, May 2020, Wiley,
DOI: 10.1111/ggi.13904.
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