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Long-term outcome of group B streptococcal meningitis
Insights
Group B Streptococcus meningitis can cause severe outcomes in infants. However, survivors without major neurologic sequelae often function normally compared to siblings.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal sepsis and meningitis.
- GBS meningitis poses a serious threat to infant health and development.
Purpose of the Study:
- To assess the long-term neurologic, psychologic, and academic outcomes of children with GBS meningitis.
- To compare the functional status of GBS meningitis survivors with their unaffected siblings.
Main Methods:
- A cohort of 74 infants with GBS meningitis was studied.
- Survivors underwent comprehensive evaluations including physical, neurologic, hearing, intellectual, perceptual-motor, and behavioral assessments.
- Comparisons were made between affected children and their siblings.
Main Results:
- 12% of children experienced major neurologic sequelae, including spastic quadriparesis, profound mental retardation, hemiparesis, deafness, or blindness.
- Six children developed acute hydrocephalus; two improved after shunt placement.
- Children surviving GBS meningitis without major sequelae generally showed normal intellectual, social, and academic functioning, comparable to their siblings.
Conclusions:
- GBS meningitis can lead to severe, long-term neurologic deficits in a subset of survivors.
- Early identification and management of complications like hydrocephalus may improve outcomes.
- Children who recover without significant sequelae demonstrate functional abilities comparable to their peers.
Abstract:
Group B Streptococcus is a common cause of neonatal sepsis and meningitis. The purpose of this study was to evaluate the neurologic, psychologic, and academic status of children who had group B streptococcal meningitis and to compare these children with their siblings. Seventy-four children who acquired group B streptococcal meningitis between one day and 6 months of life formed the study population. Survivors were 3 to 18 years old at the time of their follow-up evaluations. Twenty children (27%) died, two were institutionalized, one severely affected child died at age 2 years, 15 were assessed by phone interview, and two were lost to follow-up. Thirty-four children and 21 siblings were comprehensively evaluated with physical and neurologic examinations, hearing tests, and tests of intellectual, perceptual-motor, and behavioral-adaptive functions. Of the total population, nine children (12%) had major neurologic sequelae (spastic quadraplegia, profound mental retardation, hemiparesis, deafness, or blindness). Six children had acute hydrocephalus; two were doing well after shunt placement. In general, those children surviving group B streptococcal meningitis without major sequelae appeared to be functioning normally or comparably to their sibling in intellectual, social, and academic matters.