Long-term sequelae of pneumococcal meningitis in children

Author(s): Kavaliotis, J., Tsikoulas, J., Andrianopoulos, P., Venzon, D., Manios, S.

Journal/Book: Clin Pediat. 1996; 35: 500 Executive Blvd, Ossining, NY 10562. Cortlandt Group. 72-78.

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 il 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.

Note: Article A Pikis, Childrens Natl Med Ctr, Dept Infect Dis, 111 Michigan Ave NW, W35, Suite 100, Washington, DC 20010 USA

Keyword(s): HEMOPHILUS-INFLUENZAE MENINGITIS; CHILDHOOD BACTERIAL-MENINGITIS; CHLORAMPHENICOL; AMPICILLIN; RESISTANCE; MORTALITY; OUTCOMES; THERAPY

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