Advertisement

The Indian Journal of Pediatrics

, Volume 69, Issue 11, pp 951–955 | Cite as

Sensorineural hearing loss following acute bacterial meningitis in non-neonates

  • B. Cherian
  • T. Singh
  • B. Chacko
  • A. Abraham
Original Article

Abstract

Objective : Sensorineural hearing loss (SNHL) is an important sequelae of acute bacterial meningitis (ABM) in children. This study was undertaken to determine the incidence of SNHL following meningitis in non-neonates and its correlation with various factors.Methods : Children between the ages of 1 month and 12 years with ABM admitted in a teaching hospital over a period of 18 months were enrolled. Detailed history was taken, clinical examination performed and cerebrospinal fluid analyzed at commencement of therapy, 48 hours later and at the end of treatment. On discharge brainstem evoked response audiometry (BERA) was recorded. Data were analyzed using appropriate statistical tests.Results : Out of 32 children enrolled, 9 (28.1%) developed SNHL, bilateral in 21.9% and unilateral in 6.2%. Among hearing impaired subjects, 11.2% had mild while 44.4% each had moderate and profound hearing loss. Age, presence of vomiting, altered sensorium seizures and aminoglycoside usage were not significantly different in those with and without SNHL, but the total duration of fever was (p <0.05). There was significantly higher protein content and neutrophils in the second CSF sample of those with SNHL.Conclusion : There is a greater than 50% probability of the child developing SNHL if neutrophil percentage in the second CSF is 80% or more. Since the overall risk of SNHL is significant in children with meningitis, it is recommended that BERA be recorded in all, so that early intervention may be possible.

Key words

Meningitis Hearing loss Non-neonates 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Mason AJ, Herrmann RK. Universal infant hearing screening by automated auditory brainstem response measurement.Pediatrics 1998; 101: 221–228.PubMedCrossRefGoogle Scholar
  2. 2.
    Fortnum HM. Hearing impairment after bacterial meningitis : a review.Arch Dis Child 1992; 1128–1133.Google Scholar
  3. 3.
    Damodaran A, Aneja S, Malhotra VL. Sensorineural hearing loss following acute bacterial meningitis. A prospective evaluation.Ind Pediatr 1996; 33: 763–766.Google Scholar
  4. 4.
    Aneja S, Aggarwal A. Acute bacterial meningitis. Ind Pediatr 1997; 34: 1097–1109.Google Scholar
  5. 5.
    Dodge RP, Davis H, Feigin DRet al. Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis.N Engl J Med 1984; 311 (14): 869–874.PubMedCrossRefGoogle Scholar
  6. 6.
    Pomeroy LS, Sandra JH, Dodge PR. Seizures and other neurologic sequelae of bacterial meningitis in children.N Engl J Med 1990; 323: 1651–657.PubMedCrossRefGoogle Scholar
  7. 7.
    Lebel MH, Hoyt J, Waagner DC, Rollins NK, Finitzo T, McCracken GH. Magnetic Resonance Imaging and Dexamethasone Therapy for Bacterial Meningitis.Am J Dis Child 1989; 143: 301–306.PubMedGoogle Scholar
  8. 8.
    Damodaran A, Aneja S, Malhotra VL: Sensorineural hearing loss following acute bacterial meningitis. A prospective evaluation.Ind Pediatr 1996; 33 : 763–766.Google Scholar
  9. 9.
    Taylor GH, Milkis LE, Clampi A, Berger DU, Watters VG, Gold Ret al. The sequelae of haemophilus influenzae meningitis in school age children.N Engl J Med 1990; 323: 1657–63.PubMedCrossRefGoogle Scholar
  10. 10.
    Rasmussen N, Johnsen JN, Bohr AV. Otologic sequelae after pneumococcal meningitis: A survey of 154 consecutive cases with a follow up of 94 survivors.Laryngoscope 1991; 101 : 876–882.PubMedCrossRefGoogle Scholar
  11. 11.
    Nadol JB: Hearing loss as a sequela of meningitis.Laryngoscope 1978; 88 : 739–755.PubMedGoogle Scholar
  12. 12.
    Dodge RP, Davis H, Feigin DRet al. Prospective evaluation of hearing impairment as a sequela of acute bacterial meningitis.N Engl J Med 1984; 311 (14): 869–874.PubMedCrossRefGoogle Scholar
  13. 13.
    Ozdamar O, Kraus N, Stein L. Auditory brainstem responses in infants recovering from bacterial meningitis.Arch Otolaryngol 1983; 109: 13–18.PubMedGoogle Scholar
  14. 14.
    Kilpi T, Anttila M, Markku J, Kallio T, Peltola H. Severity of childhood bacterial meningitis and duration of illness before diagnosis.Lancet 1991; 338: 406–409.PubMedCrossRefGoogle Scholar
  15. 15.
    Kaplan LS, Smith OE, Wills C, Feigin DR. Association between preadmission oral antibiotic therapy and cerebrospinal fluid findings and sequelae caused by haemophilus influenzae type b meinigitis.Pediatr Infect Dis 1986; 5 (6): 626–632.PubMedGoogle Scholar
  16. 16.
    Salih MAM, Khaleefa HO, Bushara M: Long term sequelae of childhood. Acute bacterial meningitis in a developing country.Scand J Infect Dis 1991; 23 : 175–182.PubMedCrossRefGoogle Scholar
  17. 17.
    Jayakumar V. Current therapy of Pyogenic Meningitis. LAP J Pract Pediatr 2000; 2: 43–50.Google Scholar
  18. 18.
    Herson CV, Todd KJ. Prediction of morbidity in hemophilus influenzae meningitis.Pediatrics 1977; 59 (1): 35–39.PubMedGoogle Scholar
  19. 19.
    Feldman MH, Michaels HR. Academic achievement in children ten to 12 years after haemophilus influenzae meningitis.Pediatrics 1988; 81: 339–344.PubMedGoogle Scholar
  20. 20.
    Vienny H, Despland PA, Liitschg J. Early diagnosis and evolution of deafness in childhood bacterial meningitis: A study using brainstem auditory evoked potentials.Pediatrics 1984; 73 : 579–586.PubMedGoogle Scholar
  21. 21.
    Kotagal S, Rosenberg C, Rudd D, Dunkle ML, Horenstein S. Auditory evoked potentials in bacterial meningitis.Arch Neurol 1981; 38: 693–695.PubMedGoogle Scholar
  22. 22.
    Ashraf H. Changes in auditory brainstem response as a sequele of bacterial meningitis.Ind J Otol 1999; 5 (1): 45–48.Google Scholar
  23. 23.
    Baraff JH, Lee IS, Schriger DL. Outcome of bacterial meningitis in children: a meta analysis.Pediatr Infect Dis J 1993; 12 : 389–94.PubMedCrossRefGoogle Scholar
  24. 24.
    Sande MA, Mandell GL. Antimicrobial agents. In Gilman AG, Rall TW, Nies AS, Taylor P, eds.The Pharmacological Basis of Therapeutics. 8th edn. New York, Pergamon Press, 1990: pp 1098–1116.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2002

Authors and Affiliations

  1. 1.Deptt. of PediatricsChristian Medical CollegeLudhiana, Punjab
  2. 2.Department of NeurologyChristian Medical CollegeLudhiana, PunjabIndia

Personalised recommendations