Long-Term Sequelae of Pneumococcal Meningitis in Children

Abstract

The purpose of this study was to assess the long-term effects of pneumococcal meningitis in children. From 1967 to 1988, a total of 90 children were admitted to the Hospital for Infectious Diseases, Thessaloniki, Greece, with the diagnosis of pneumococcal meningitis. Sixteen patients died in the hospital as a direct result of meningitis. Eleven others were excluded from the study (neurologic deficits prior to onset of meningitis, two; death subsequent to hospitalization, two; recurrent meningitis, seven). Of the remaining 63 survivors, we were able to evaluate 47 patients (75%). Evaluation was performed 4 to 23 years (mean 12.3 +/- 5.8 years) after discharge. Forty patients returned to hospital for evaluation, and seven were evaluated by their primary physicians, who sent information by a standardized questionnaire. The following examinations were carried out: history, physical and neurologic examination, ophthalmologic and hearing evaluation, and psychometric testing. Fourteen patients (30%) had at least one neurologic handicap; nine (19%) had mental retardation, eight (17%) hearing loss, seven (15%) seizure disorder, five (11%) motor defects, and one each (2%) behavioral problems and visual impairment. The presence of coma was the strongest predictor of increased morbidity. The high frequency of long-term sequelae observed in our study supports the need of an effective vaccine.

Long-term outcomes of pneumococcal meningitis in childhood and adolescence

“…However, the proportion of patients reporting partial or profound hearing loss in our study (26%) is highly comparable with estimates from other studies [23] that suggest 30% [2] of children and 22% of adults [31] have hearing loss after PM.…”

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

“…The literature search identified 15 cases in which the authors suggested that a chronic parameningeal focus had been the source of recurrent episodes of meningitis (11,56,78,102,124,127,161,167,169,215). This group comprised 11 cases of chronic otitis media and/or mastoiditis, two cases of chronic sinusitis (sphenoidal and maxillary), and two cases of chronic osteomyelitis of the skull (Table 3).…”

The risk of sequelae due to pneumococcal meningitis in high-income countries: A systematic review and meta-analysis

“…The corresponding estimate in this paper using only studies on patients recruited after 1990 is 23.9%, 6.2% and 9.4%. Mental retardation, a further category reported by Baraff and co-workers, was not extracted because only two studies reported such a diagnosis, and the two studies used imprecise but non-equivalent descriptions ("severe mental retardation" 25 and "mental retardation" 24 ).…”