Related Experiment Videos
Long-term sequelae of group B streptococcal meningitis in infants
Insights
Group B streptococcal meningitis can be fatal, but survivors often experience long-term neurologic deficits. Early detection of severe symptoms in infants is crucial for predicting poor outcomes in meningitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Group B Streptococcus (GBS) is a leading cause of bacterial meningitis in neonates.
- Long-term outcomes and predictive factors for GBS meningitis require further elucidation.
Purpose of the Study:
- To determine the long-term outcomes of GBS meningitis.
- To identify admission features that predict outcomes in GBS meningitis.
Main Methods:
- Retrospective analysis of 61 patients with GBS meningitis treated between 1974 and 1979.
- Comprehensive neurodevelopmental evaluation of survivors aged 3 years or older.
Main Results:
- Mortality rate was 21% (13/61).
- Among survivors, 50% had normal function, 21% had mild-moderate deficits, and 29% had severe neurologic sequelae.
- Comatose state, decreased perfusion, low WBC (<5,000/mm3), low absolute neutrophil count (<1000/mm3), and high CSF protein (>300 mg/dl) at admission predicted poor outcomes (P ≤ 0.05).
Conclusions:
- Despite declining mortality, approximately half of GBS meningitis survivors experience significant long-term morbidity.
- Early clinical and laboratory findings at hospital admission are critical predictors of mortality and severe neurologic impairment in infants with GBS meningitis.
Abstract:
The long-term outcome and admission features predictive of outcome were determined for 61 patients with group B streptococcal meningitis treated between 1974 and 1979. Infection was rapidly fatal in 13 patients (21%). Among the 48 survivors, 38 (79%) 3 years of age or older were available for comprehensive evaluation. Excluding five who had died before age 3 years, the mean age at evaluation was 6.0 years (range 3.3 to 9.0 years). Among survivors, 11 (29%) had severe neurologic sequelae, eight (21%) had mild to moderate deficits, and 19 (50%) were functioning normally. Analysis of predictive features revealed a significant risk of death or severe impairment among infants who at hospital admission were comatose or semicomatose, had decreased perfusion, total peripheral WBC less than 5,000/mm3, absolute neutrophil count less than 1000/mm3, and CSF protein greater than 300 mg/dl (P less than or equal to 0.05). These data indicate that, although mortality from group B streptococcal meningitis has declined, approximately half of the survivors of acute infection have some degree of morbidity when evaluated at ages permitting the detection of language delay and borderline or mild mental retardation.