HEARING IMPAIRMENT AFTER BACTERIAL-MENINGITIS - A REVIEW

The recent literature reports the incidence of permanent sensorineural hearing impairment in children surviving bacterial meningitis to be approximately 10%. The question of why some children surviving bacterial meningitis suffer a hearing impairment while others recover completely remains unanswered. Very few of the factors so far studied have any predictive power. Knowledge of those that do, for example low concentrations of cerebrospinal fluid glucose, may improve our understanding of the pathological mechanisms involved and ultimately possibly lead to methods of prevention, but at present do not allow useful prediction of those who will be affected. The role of steroids and non-steroidal anti-inflammatory agents needs further investigation. These may yet prove to be useful interventions to prevent mortality and morbidity caused by bacterial meningitis. The best hope of preventing serious sequelae of bacterial meningitis is primary prevention and currently vaccination offers the most promising solution. Further research will no doubt expand the range of causative organisms covered. Up to date epidemiological studies of the UK population are needed to enable an accurate assessment of the extent of the problem and the potential health gain from advances in prevention or treatment. Children will continue to suffer bacterial meningitis. Most will survive but some of them will be left with impaired hearing. Such children must be identified as quickly as possible to enable timely secondary prevention of disability or handicap.