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Published on: February 29, 2020
Postmeningitic pediatric hearing loss from non-type b Haemophilus influenzae
Brian W Herrmann1, Salina H Goff2, Juri Boguniewicz3
1Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States of America; Children's Hospital Colorado, United States of America.
Background:
Postmeningitic hearing loss from Haemophilus influenzae (H. influenzae) is increasingly due to encapsulated serotypes other than type b (Hib) and nontypeable strains (collectively, nHiB H. influenzae). Pediatric hearing loss after nHib H. influenzae meningitis remains poorly described.
Methods:
Retrospecive case series of nHiB H. influenzae meningitis cases identified from a microbiologic database at Children's Hospital Colorado from 2000 to 2020. Literature regarding nHiB H. influenzae and H. influenzae postmeningitic hearing loss was also reviewed.
Results:
Eleven cases of nHib H. influenzae meningitis (median age 15.9 months) were identified due to serotype f (36 %), serotype a (27 %), and nontypable strains (36 %). Seven (64 %) patients were male, 55 % were white and 18 % were Hispanic or Latino. Hearing loss was initially identified in 4 children (40 %), with two patients with moderate conductive hearing loss (CHL) and one child with unilateral moderate sensorineural (SNHL) hearing loss patients recovering normal hearing. One patient with bilateral profound sensorineural hearing loss and associated labyrinthitis ossificans required cochlear implantation. All children (4) with identified hearing loss were noted to have additional intracranial sequelae, which included empyema (2), sinus thrombosis (2), and seizures (2). Of patients receiving steroids, 25 % had hearing loss on initial testing, compared to 66 % of those who did not receive steroids.
Conclusions:
nHib H. influenzae can cause both transient and permanent postmeningitic hearing loss. Steroids may offer otoprotection in nHib H. influenzae meningitis similar to Hib meningitis. Given the limited literature, further study is needed to better characterize hearing outcomes after nHib H. influenzae meningitis.
Insights
Non-typeable Haemophilus influenzae (nHIB) meningitis can cause temporary or permanent hearing loss in children. Steroid treatment may protect hearing, but more research is needed to understand outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Neurology
Background:
- Postmeningitic hearing loss is increasingly linked to non-typeable Haemophilus influenzae (nHIB) strains, not just Hib.
- Pediatric hearing loss following nHIB H. influenzae meningitis is not well-documented.
Purpose of the Study:
- To describe hearing outcomes in children with nHIB H. influenzae meningitis.
- To investigate the potential otoprotective effect of steroids in nHIB H. influenzae meningitis.
Main Methods:
- Retrospective case series of nHIB H. influenzae meningitis at Children's Hospital Colorado (2000-2020).
- Literature review on nHIB H. influenzae and postmeningitic hearing loss.
Main Results:
- Eleven pediatric cases of nHIB H. influenzae meningitis identified (serotypes f, a, and non-typable).
- 40% of patients had initial hearing loss; outcomes ranged from recovery to profound sensorineural hearing loss requiring cochlear implantation.
- Children with hearing loss also experienced intracranial sequelae like empyema, sinus thrombosis, and seizures.
- Steroid use was associated with a lower incidence of initial hearing loss (25% vs. 66%).
Conclusions:
- nHIB H. influenzae meningitis can lead to transient and permanent hearing loss.
- Steroids may offer otoprotection, similar to Hib meningitis.
- Further research is required to fully understand hearing outcomes after nHIB H. influenzae meningitis.
