A 7-year-old boy who had recurrent attacks of Streptococcus pneumoniae meningitis was admitted. The mother reported a history of mild head trauma two months prior to the first episode. On further enquiry it was discovered that the patient had a history of right ear discharge during early childhood with no recollection by the family of the exact time and duration. There was no history of recurrent sinopulmonary infections or hearing difficulties. Workup included auditory testing, which showed right-sided profound sensorineural hearing loss, a high-resolution temporal bone CT scan (Figure 1a), and MRI (Figure 2b).
Figure 1a.
CT scan of the right petrous bone
Figure 2a.
MRI of the temporal bones
What are the abnormal findings on the CT scan and MRI of the temporal bone?
Name the associated condition?
Why are patients with this condition at risk of meningitis?
Answer on page 163