Objective:Sensorineural hearing loss is a common sequela of bacterial meningitis. The objective of this study is to delineate the incidence and course of hearing loss after bacterial meningitis.Study Design:Retrospective cohort study.Setting:Tertiary referral center.Patients:Data of 655 patients who suffered from bacterial meningitis between 1985 and 2015 were analyzed.Interventions:None.Main Outcome Measurements:Availability of audiometric data, incidence of hearing loss, and onset and course of hearing loss.Results:In this cohort the incidence of hearing loss (>25 dB) was 28% (95% confidence interval 23–34%). The incidence of profound hearing loss (>80 dB) was 13% (95% confidence interval 10–18%). Normal hearing at the first assessment after treatment for meningitis remained stable over time in all these patients. In 19 of the 28 patients with diagnosed hearing loss, the hearing level remained stable over time. Hearing improved in six patients and deteriorated in two patients. One patient showed a fluctuating unilateral hearing loss.Conclusion:Audiological tests in patients with bacterial meningitis, especially children, should be started as soon as possible after the acute phase is over. As we found no deterioration of initial normal hearing after bacterial meningitis, repeated audiometry seems indicated only for those with diagnosed hearing loss at first assessment.

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The overall quality of the included studies was poor. A major drawback was the quality of the (description of) audiometry, severity, and timing of hearing loss.A systematic review of the literature showed an incidence of hearing loss (>25 ± 5  dB) of 14% and an incidence of 5% for profound hearing loss (>90  dB). Patients with initial normal hearing after meningitis showed stable normal hearing over time. However, initial hearing loss related to meningitis can improve or deteriorate over time.We therefore recommend early audiological testing of all patients who suffered bacterial meningitis. However, long-term audiological follow-up is only needed for patients with early onset hearing loss and not for patients with normal hearing at the first hearing test.