Neurological sequelae after childhood bacterial meningitis.

Area of Science:

• Pediatrics
• Infectious Diseases
• Neurology

Background:

• Bacterial meningitis (BM) continues to pose a significant risk of mortality and severe sequelae despite medical advancements.
• Streptococcus pneumoniae and Neisseria meningitidis are identified as the primary bacterial pathogens responsible for childhood BM.

Purpose of the Study:

• To evaluate the incidence, clinical presentation, pathogens, diagnostics, and outcomes of childhood bacterial meningitis.
• To assess neurological sequelae, hearing loss, and mortality rates associated with pediatric BM.
• To identify potential risk factors for death, unfavorable outcomes, and long-term neurological sequelae in children with BM.

Main Methods:

• A retrospective review of pediatric patients diagnosed with BM between 2010 and 2020 at a tertiary children's center.
• Utilized the Glasgow Outcome Scale (GOS) to classify outcomes, with scores 1-4 indicating an unfavorable outcome.
• Employed logistic regression univariate analysis to determine risk factors for adverse outcomes.

Main Results:

• The study included 74 patients (77 BM episodes) with an average BM incidence of 2.2/100,000/year, predominantly community-acquired (91%).
• Streptococcus pneumoniae and Neisseria meningitidis were the most common pathogens (16% each).
• Neurological sequelae were observed in 32% of survivors at long-term follow-up, with aphasia/dysphasia being most common (17%); 9% of patients died, and 3% experienced hearing loss.

Conclusions:

• Bacterial meningitis (BM) still carries a significant risk of mortality.
• A substantial proportion of BM survivors experience persistent neurological sequelae, particularly aphasia/dysphasia, and 3% develop hearing loss.
• No independent risk factors were identified for predicting long-term neurological sequelae in this cohort.