LONG-TERM SEQUELAE OF GROUP-B STREPTOCOCCAL MENINGITIS IN INFANTS

The long-term outcome and admission features predictive of outcome were determined for 61 patients with group B steptococcal meningitis. Infection was rapidly fatal in 13 patients (21%). Among the 48 survivors, 38 (79%) 3 yr of age or older were available for comprehensive evaluation. Excluding 5 who had died before age 3 yr, the mean age at evaluation was 6.0 yr (range 3.3-9.0 yr). Among survivors, 11 (29%) had severe neurologic sequelae, 8 (21%) had mild to moderate deficits, and 19 (50%) were functioning normally. Analysis of predictive features revealed a significant risk of death or severe impairment among infants who at hospital admission were comatose or semicomatose, had decreased perfusion, total peripheral WBC [white blood cell] < 5000/mm3, absolute neutrophil count < 1000/mm3, and CSF protein > 300 mg/dl (P .ltoreq. 0.05). These data indicate that, although mortality from group B streptococcal meningitis has declined, approximately half of the survivors of acute infection have some degree of morbidity when evaluated at ages permitting the detection of language delay and borderline or mild mental retardation.