2) The Spread of the Infection
is more common in neglected cases of middle ear infection. Atypical causative organisms or resistant strains of bacteria may not respond to therapy and spread in the surrounding tissues. Bacterial infection may reach the mastoid bone behind the ear resulting in acute mastoiditis. Acute mastoiditis appears as a congestive painful swelling over the bony protrusion behind the ear. Chronic otitis media may form fluid cysts or abnormal masses in the middle ear.
In rare cases, the infection spreads from the middle ear to the intracranial tissues such as the meninges covering the brain matter. Inflammation of the meninges (meningitis) is the most common intracranial complication of otitis media followed by brain abscess. Meningitis is a serious condition and should be treated carefully. The frequent signs that may indicate the development of meningitis are neck stiffness, severe headache, and projectile vomiting. Infection may spread to the inner ear causing labyrinthitis that may cause irreversible damage to the neural endings precepting sound waves.
