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Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis
Insights
Bacterial meningitis in children can cause lasting hearing loss, particularly with Streptococcus pneumoniae. Early treatment doesn't prevent sensorineural hearing deficits.
Area of Science:
- Pediatrics
- Infectious Diseases
- Audiology
Background:
- Acute bacterial meningitis is a serious childhood infection.
- Hearing impairment is a potential complication of meningitis.
- Long-term hearing outcomes require further investigation.
Purpose of the Study:
- To assess the incidence and characteristics of hearing loss in children following acute bacterial meningitis.
- To identify specific bacterial pathogens associated with higher risks of hearing impairment.
- To evaluate the correlation between treatment delay and the development of hearing deficits.
Main Methods:
- Prospective study of 185 children with acute bacterial meningitis (age > 1 month).
- Hearing evaluated using electric-response audiometry and conventional tests.
- Incidence of hearing loss analyzed based on causative pathogen (Streptococcus pneumoniae, Neisseria meningitidis, Hemophilus influenzae).
Main Results:
- 10.3% of patients developed persistent sensorineural hearing loss.
- Hearing loss incidence varied by pathogen: 31% for Streptococcus pneumoniae, 10.5% for Neisseria meningitidis, 6% for Hemophilus influenzae.
- 16% experienced transient conductive hearing impairment; no improvement in sensorineural deficits was observed.
Conclusions:
- Acute bacterial meningitis frequently leads to sensorineural hearing loss in children.
- Streptococcus pneumoniae poses the highest risk for hearing impairment.
- The exact site of auditory system damage is uncertain, but inner ear or auditory nerve involvement is suspected.
Abstract:
As part of a prospective study of acute bacterial meningitis in children, we studied for five years the hearing of 185 infants and children who had acute bacterial meningitis when they were more than one month of age. Nineteen (10.3 per cent) of the patients had persistent bilateral or unilateral sensorineural hearing loss. The incidence of hearing loss as determined by electric-response audiometry and conventional tests was 31 per cent with Streptococcus pneumoniae, 10.5 per cent with Neisseria meningitidis, and 6 per cent with Hemophilus influenzae infections. Transient conductive hearing impairment was found in 16 per cent of the sample, but in no case was there apparent improvement in a sensorineural deficit over time. The site of disease resulting in impaired hearing cannot be stated with certainty, but involvement of the inner ear or auditory nerve was suspected. The number of days of illness (symptoms) before hospitalization and institution of antibacterial treatment was not correlated with the development of sensorineural deafness.