Chronic Meningitis Due to Otitis Media With Cholesteatoma in a Five-Year-Old Child With a Cochlear Implant

Cochlear implants (CIs) restore hearing in patients with severe-to-profound deafness. Post-CI meningitis is a rare but redoubted complication. We present the case of a five-year-old CI recipient who experienced an episode of chronic meningitis caused by chronic otitis media with cholesteatoma encasing the electrode lead. We hypothesize that the cholesteatoma led to an ascending infection to the cochlea, passing through the labyrinths, resulting in chronic meningitis. Although positive neural responses were initially noted on cochlear electrical stimulation, these responses resolved a few weeks after reimplantation. Our report highlights the importance of careful otoscopic examination and diagnostic work-up in patients presenting with otogenic meningitis to rule out cholesteatoma formation and to ensure prompt surgical exploration if warranted.