Prospective Evaluation of Hearing Impairment as a Sequela of Acute Bacterial Meningitis

Dodge, Philip R.; Davis, Hallowell; Feigin, Ralph D.; Holmes, Scott A.; Kaplan, Sheldon L.; Jubelirer, David P.; Stechenberg, Barbara W.; Hirsh, S. K.

doi:10.1056/nejm198410043111401

Cited by 324 publications

(193 citation statements)

References 26 publications

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“…Vários autores destacam a meningite bacteriana como uma das principais causas de surdez adquirida após o nascimento 7 . Do ponto de vista fisiopatológico, a perda auditiva na meningite bacteriana provavelmente ocorre no início da doença, durante a fase de bacteremia, antes que se evidenciem os sinais e sintomas clínicos.…”

Section: Discussionunclassified

Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças

et al. 1996

Arq. Neuro-Psiquiatr.

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RESUMO -Foram estudadas prospectivamente 55 crianças que apresentaram meningite bacteriana no período neonatal, com o objetivo da analisar a frequência e o tipo de sequelas neurológicas. Todas as crianças nasceram a termo, sendo 38 do sexo masculino e 17 do feminino; a idade de início da doença variou de 3 a 28 dias. Os principais agentes etiológicos foram as enterobactérias. O tempo médio de seguimento foi 5 anos. A frequência de sequelas neurológicas foi 67,3%, representadas principalmente pelo atraso do desenvolvimento neuropsicomotor (58,2%), hidrocefalia (45,5%) e convulsões (34,5%). As alterações motoras graves ocorreram em 23,6% dos pacientes (tetraplegia, diplegia, hemiparesia e ataxia). As convulsões na fase aguda da doença e a cultura positiva do líquido cefalorraqueano estiveram associadas significativamente com a presença de sequelas. Na avaliação do desempenho escolar, realizada em 25 crianças, observaram-se dificuldades na aprendizagem em 48% dos casos, associadas significativamente à deficiência mental.PALAVRAS-CHAVE: recém-nascido, meningite, seguimento.Vários estudos têm mostrado que a meningite bacteriana neonatal representa causa importante de morbimortalidade infantil, apesar dos avanços nas áreas da terapêutica antimicrobiana e cuidados Neonatal bacterial meningitis: prospective study of the long term outcome of 55 childrenABSTRACT -Fifty-five infants who presented bacterial neonatal meningitis were prospectively studied to analyze the frequency and the type of sequelae. All the infants were full term newborns.There were 38 boys and 17 girls; the age of disease onset varied from 3 to 28 days. The causative organism was represented mainly by enterobacteriae. The median time of follow-up was 5 years. The frequency of neurologic sequelae was 63.7%, represented mainly by neuropsychomotor development delay (58.2%), hydrocephaly (45.5%) and convulsions (34.5%). Severe motor abnormalities ocurred in 23.6% of children (quadriplegia, diplegia, hemiparesia and ataxia). Convulsions in the acute phase of the disease and the positive cerebrospinal fluid culture were highly associated to sequelae. The school performance, obtained in 25 children, showed presence of disabilities in 48% of cases, which were significantly associated to mental retardation.

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Section: Discussionunclassified

Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças

et al. 1996

Arq. Neuro-Psiquiatr.

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“…The most common neurological complication in children is some degree of sensorineural hearing impairment. A prospective study of acute bacterial meningitis in children showed that "'-' I0% of patients had persistent bilateral or unilateral sensorineural hearing loss [17]. This impairment is most likely secondary to cochlear dysfunction due to the presence of viable bacteria in the cochlea and cochlear aqueduct.…”

Section: Morphological Alterations During Bacterial Meningitismentioning

confidence: 99%

Mechanisms of Brain Injury in Bacterial Meningitis: Workshop Summary

Pfister

Fontana²,

Täuber³

et al. 1994

Clinical Infectious Diseases

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Morbidity and mortality associated with bacterial meningitis remain high, although antibiotic therapy has improved during recent decades. The major intracranial complications of bacterial meningitis are cerebrovascular arterial and venous involvement, brain edema, and hydrocephalus with a subsequent increase of intracranial pressure. Experiments in animal models and cell culture systems have focused on the pathogenesis and pathophysiology of bacterial meningitis in an attempt to identify the bacterial and/or host factors responsible for brain injury during the course of infection. An international workshop entitled "Bacterial Meningitis: Mechanisms of Brain Injury" was organized by the Department of Neurology at the University of Munich and was held in Eibsee, Germany, in June 1993. This conference provided a forum for the exchange of current information on bacterial meningitis, including data on the clinical spectrum of complications, the associated morphological alterations, the role of soluble inflammatory mediators (in particular cytokines) and of leukocyte-endothelial cell interactions in tissue injury, and the molecular mechanisms of neuronal injury, with potential mediators such as reactive oxygen species, reactive nitrogen species, and excitatory amino acids. It is hoped that a better understanding of the pathophysiological events that take place during bacterial meningitis will lead to the development of new therapeutic regimens.Although the recent licensure of Haeniophilus influenzae type b (Hib) polysaccharide conjugate protein vaccines has had a marked impact on the incidence of invasive Hib disease in the United States and Western Europe. bacterial meningitis overall remains a significant problem worldwide. In addition, despite the introduction of new antimicrobial agents and improved diagnostic techniques, the mortality and morbidity associated with bacterial meningitis remain unacceptably high. This discrepancy between a rapid bacteriologic response at the site of infection (i.e .. eradication of viable bacteria from the CSF due to treatment with potent bactericidal agents) and the persistence of the associated neurological sequelae and mortality has prompted intense investigation over the past two decades into the pathophysiology of this disease. Indeed. recent clinical studies have employed adjunctive agents (e.g .. dexamethasone) in an attempt to reduce mortality and alleviate neurological sequelae [1][2][3][4]. These studies and the resulting recommendations regarding the use of adjunctive dexamethasone have recently been reviewed [5.6].In line with the current emphasis on the pathogenesis and pathophysiology of bacterial meningitis. two workshops were held in California in the 1980s [7]. Recognizing that many advances have been made in this field in the several years since those meetings. the Department of Neurology at the University of Munich organized a similar workshop, which was held in Eibsce. Germanv. on 25 and 26 June 1993. As IS evident from its title-"Bacterial Meningitis: Mechanisms...

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“…For example, microbial infections of the middle ear, such as with Streptococcus pneumoniae (Dodge et al ., 1984), Haemophilus influenzae type B (Feldman et al ., 1982), or cytomegalovirus (Bradford et al . 2015), can spread to the inner ear and induce inflammation resulting in sensorineural hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Activation of TRAIL‐DR5 pathway promotes sensorineural degeneration in the inner ear

et al. 2016

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SummaryTumor necrosis factor (TNF) family cytokines are important mediators of inflammation. Elevated levels of serum TNF‐α are associated with human sensorineural hearing loss via poorly understood mechanisms. We demonstrate, for the first time, expression of TNF‐related apoptosis‐inducing ligand (TRAIL) and its signaling death receptor 5 (DR5) in the murine inner ear and show that exogenous TRAIL can trigger hair cell and neuronal degeneration, which can be partly prevented with DR5‐blocking antibodies.

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Prospective Evaluation of Hearing Impairment as a Sequela of Acute Bacterial Meningitis

Cited by 324 publications

References 26 publications

Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças

Meningite bacteriana neonatal: estudo prospectivo da evolução a longo prazo de 55 crianças

Mechanisms of Brain Injury in Bacterial Meningitis: Workshop Summary

Activation of TRAIL‐DR5 pathway promotes sensorineural degeneration in the inner ear

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