A1 Refereed original research article in a scientific journal
Neurological sequelae after childhood bacterial meningitis
Authors: Lempinen, Laura; Saat, Riste; Niemelä, Sakke; Laulajainen-Hongisto, Anu; Aarnisalo, Antti A.; Nieminen, Tea; Jero, Jussi
Publisher: Springer Science and Business Media LLC
Publication year: 2024
Journal: European Journal of Pediatrics
Journal name in source: European Journal of Pediatrics
Journal acronym: Eur J Pediatr
ISSN: 0340-6199
eISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05788-w
Web address : https://doi.org/10.1007/s00431-024-05788-w
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/458339289
The purpose of this study is to evaluate childhood bacterial meningitis (BM): incidence, clinical presentation, causative pathogens, diagnostics, and outcome (neurological sequelae, hearing loss, and death). A retrospective review of all children aged ≤ 16 years and 1 month diagnosed with BM at a tertiary children's centre in the period 2010-2020. The Glasgow Outcome Scale (GOS) was used to assess outcome, with a GOS score of 1-4 considered to be an unfavourable outcome. Logistic regression univariate analysis was used to determine predefined risk factors for death, unfavourable outcome, and long-term neurological sequelae. Seventy-four patients (44 males) with a median age of 8.0 months (range 1 day to 16 years and 1 month) and 77 BM episodes were included in the study. The average incidence rate of BM was 2.2/100,000/year, the majority (91%) being community-acquired BM. Streptococcus pneumonia and Neisseria meningitidis were the most common pathogens 12/77 (16%) each. Neurological sequelae at discharge were present in 24 (34%) patients, unfavourable outcome in 19 (25%), and hearing loss (deafness) in two (3%) survivors of BM. Seven (9%) patients died. Long-term neurological sequelae were observed in 19/60 (32%), aphasia/dysphasia being the most common in 10 (17%) BM children. No independent risk factors were identified for long-term neurological sequelae in univariate analysis.
CONCLUSION: The risk for a fatal course of BM is still remarkable. Neurological sequelae persisted in a substantial proportion of BM survivors in long-term follow-up, aphasia/dysphasia being the most common. Hearing loss (deafness) occurred in 3%. However, no specific risk factors predicting the long-term sequelae were found.
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Funding information in the publication:
Open Access funding provided by University of Helsinki (including Helsinki University Central Hospital). This study was funded by The Research Foundation of Helsinki University Hospital (HUS Medical Imaging Center and Head and Neck Center), the Finnish Society for Study of Infectious Diseases, and the Finnish ORL-HNS Foundation. This study got the grant for an English language editing service and financial support from the Pediatric Research Center, Helsinki University Hospital.