Clinical Predictors for Hearing Loss in Children With Bacterial Meningitis

Abstract

To identify clinical risk factors that predict a higher incidence of hearing loss in children with bacterial meningitis, to determine the overall incidence of hearing loss in a large group of children proven by culture findings to have bacterial meningitis, and to compare clinical characteristics among patients with Streptococcus pneumoniae meningitis and Neisseria meningitidis meningitis. Design: Retrospective review Setting: Tertiary pediatric hospital. Patients: A total of 171 children identified with bacterial meningitis who met inclusion criteria over a consecutive 10-year period. Main Outcome Measure: Presence of sensorineural hearing loss. Results: Of 134 patients who underwent audiologic testing during their initial hospitalization, 41 (30.6%) were found to have at least a unilateral mild sensorineural hearing loss. The incidence of hearing loss was greater in patients with S pneumoniae meningitis than in patients with N meningitidis meningitis (35.9% and 23.9%, respectively). Length of hospitalization, development of seizures, elevated cerebrospinal fluid protein, and decreased cerebrospinal fluid glucose were significant predictors for hearing loss in children with bacterial meningitis. These factors were not found to be as strong a predictor for hearing loss in patients with N meningitidis meningitis. Stability of hearing was demonstrated with limited follow-up audiometry. Conclusions: Sensorineural hearing loss is a common sequela in children with bacterial meningitis. Identification of hearing loss in children with bacterial meningitis and early rehabilitation will lessen the long-term educational and social difficulties these children may experience.

Prevalence of hearing loss in children following bacterial meningitis in a tertiary referral hospital

“…This was therefore greater than findings of previous studies. Walter et al reported an incidence of 14% [9] consistent with other reports [2,4,10,11]. This is likely due to several factors.…”

“…There were no differences in the prevalence of hearing loss between the two groups. Walter et al showed that being male was a significant independent risk factor for hearing loss [9]. Early age at illness was identified by Grimwood et al as a significant risk factor for hearing loss, with children suffering meningitis before twelve months of age performing more poorly than children suffering meningitis later in infancy and childhood, and age-matched controls, on measures of language and reading skills [12].…”

Magnetic resonance imaging in patients with meningitis induced hearing loss

“…The incidence of meningitis induced hearing loss is different for varying causative agents such as S. pneumoniae (31–36%), N. meningitidis (8–11%) and H. influenza (6–11%) [1–3]. Meningitis induced hearing loss is probably the result of the spread of infection to the inner ear via the cochlear aqueduct or modiolus and develops at an early stage of meningitis.…”

Imaging of Pediatric Hearing Loss

“…Bacterial meningitis is the most common cause for acquired hearing loss, with 5%-35% of patients developing permanent SNHL and profound bilateral deafness occurring in up to 4% of patients. 15 Bacterial meningitis often involves a multifactorial mechanism for hearing loss, including labyrinthine involvement, cochlear neuroepithelial damage, and vascular insult. 15 In addition to bacterial meningitis, labyrinthitis can also cause an acquired form of SNHL.…”

“…15 Bacterial meningitis often involves a multifactorial mechanism for hearing loss, including labyrinthine involvement, cochlear neuroepithelial damage, and vascular insult. 15 In addition to bacterial meningitis, labyrinthitis can also cause an acquired form of SNHL. Viral sources of labyrinthitis are the most common cause and present with sudden hearing loss, vertigo, or tinnitus.…”