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[Sequelae of bacterial meningitis in childhood: a study of hearing impairment]
G Palla1, A Villirillo, C Ughi
1Istituto di Clinica Pediatrica, Università degli Studi, Pisa.
Insights
Bacterial meningitis can cause lasting neurological issues, most commonly hearing loss. Early audiological assessments are crucial for children after meningitis to detect and manage potential speech and language development problems.
Area of Science:
- Neurology
- Pediatrics
- Audiology
Background:
- Bacterial meningitis is a severe central nervous system infection.
- Neurological sequelae, particularly hearing impairment, are common after meningitis.
- Early identification of audiological deficits is vital for child development.
Purpose of the Study:
- To evaluate the incidence of audiological deficits in children treated for bacterial meningitis.
- To identify potential risk factors or correlations associated with neurological sequelae.
- To emphasize the importance of audiological follow-up after meningitis.
Main Methods:
- Retrospective evaluation of 20 pediatric patients (4 months to 11 years) treated between 1988-1993.
- Clinical-neurological examinations and auditory assessments (BAEPs, impedence audiometry) conducted 1-18 months post-hospitalization.
- Analysis of patient data including illness duration, treatment, fever, consciousness, and neck rigidity.
Main Results:
- 4 children experienced persistent neurological sequelae.
- 3 patients developed sensorineural hearing loss; 1 had visual impairment and seizures.
- No correlation found between sequelae and illness duration, fever, consciousness, neck rigidity, or specific antibacterial therapy.
- Haemophilus Influenzae and Streptococcus Pneumoniae were implicated in sequelae cases.
Conclusions:
- Bacterial meningitis can lead to significant neurological and audiological deficits.
- Standard clinical indicators and treatment types did not predict sequelae.
- Comprehensive and repeated audiological assessments are recommended for all children post-meningitis to prevent speech and language issues.
Abstract:
Bacterial meningitis is an infection of the central nervous system involving quite a number of neurological sequelae the most common of which is hearing impairment. To assess the incidence of audiological deficit the authors evaluated retrospectively 20 patients, between 4 months and 11 years of age, observed at the Pediatric Clinic at the University of Pisa between 1988 and 1993. A clinical-neurological examination and a complete auditory assessment (using BAEPs and impedence audiometry) has been performed in every patient between 1 and 18 months after they left hospital. 4 children had persisting neurological sequelae, 3 patients developed sensorineural hearing loss and one child visual impairment and seizures. Haemophilus Influenzae was responsible for 2 cases of sequelae and Streptococcus Pneumoniae for the other 2 cases. The number of days of illness before hospitalization and the institution of an antibacterial treatment, persistence of fever and deviation from the normal level of consciousness and persistence of neck rigidity were not correlated with the presence of sequelae. No correlation has been found between sensorineural hearing loss and the kind of antibacterial therapy. It's advisable that every child, following bacterial meningitis, should undergo a complete and repeated audiological assessment to detect any lesser impairments and/or unilateral losses that may damage the development of speech and language in any way.