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Recurrent meningitis secondary to perilymph fistula in young children
1Department of Otolaryngology, University of Western Ontario, London, Canada.
Insights
Young children treated for meningitis require evoked potential audiometry to detect hearing loss. Neurosensory hearing loss may indicate a perilymph fistula, necessitating further investigation.
Area of Science:
- Pediatric Neurology
- Otolaryngology
- Infectious Diseases
Background:
- Meningitis in young children can lead to significant complications, including hearing loss.
- Early identification and management of hearing impairment are crucial for developmental outcomes.
- Perilymph fistula is a rare but serious potential cause of meningitis.
Observation:
- Two pediatric cases of meningitis secondary to perilymph fistula were observed.
- Diagnosis and management of this condition present unique challenges.
- Evoked potential audiometry is recommended post-meningitis treatment.
Findings:
- Neurosensory hearing loss identified via evoked potential audiometry can signal a perilymph fistula.
- Radiological imaging of the inner ear and exploratory tympanotomy may be required for diagnosis.
- Prompt identification is key to appropriate management.
Implications:
- Clinicians should consider perilymph fistula in children with meningitis and subsequent hearing loss.
- Further diagnostic steps are essential to confirm or exclude perilymph fistula.
- This highlights the importance of comprehensive audiological follow-up after meningitis treatment.
Abstract:
All young children treated for meningitis should have post-treatment evoked potential audiometry. If neurosensory hearing loss is identified, the clinician should be alerted to the possibility of a perilymph fistula as the cause of the meningitis. Radiology of the inner ear and possibly exploratory tympanotomy may be necessary to rule out a perilymph fistula. Two young children with meningitis secondary to perilymph fistula are presented to illustrate the problems of diagnosis and management.