Transmission course Pathways of spread Direct extension of infection to structure (bone erosion) Hemogenous routine (microbiologic an host factors Bacteria gain access to intracranial through unsealed gap, inner earTransmission course ◼ Pathways of spread ◼ Direct extension of infection to structure (bone erosion) ◼ Hemogenous routine (microbiologic an host factors) ◼ Bacteria gain access to intracranial through unsealed gap, inner ear