Abstract
Bacterial meningitis is a devastating infection, with a case fatality rate of up to 30% and 50% of survivors developing neurological complications. These include short-term complications such as focal neurological deficit and subdural effusion, and long-term complications such as hearing loss, seizures, cognitive impairment and hydrocephalus. Complications develop due to bacterial toxin release and the host immune response, which lead to neuronal damage. Factors associated with increased risk of developing neurological complications include young age, delayed presentation and Streptococcus pneumoniae as an etiologic agent. Vaccination is the primary method of preventing bacterial meningitis and therefore its complications. There are three vaccine preventable causes: Haemophilus influenzae type b (Hib), S. pneumoniae, and Neisseria meningitidis. Starting antibiotics without delay is also critical to reduce the risk of neurological complications. Additionally, early adjuvant corticosteroid use in Hib meningitis reduces the risk of hearing loss and severe neurological complications.
Highlights
Acute bacterial meningitis is the most common bacterial central nervous system (CNS)infection
Introduction of vaccines against Haemophilus influenzae type b (Hib), Neisseria meningitidis and Streptococcus pneumoniae over the last three decades has led to a drastic decrease in the incidence rate of bacterial meningitis beyond the neonatal period in countries with these
S. pneumoniae compared to N. meningitidis and Hib is associated with higher risk of symptomatic seizures, hydrocephalus, hearing loss and mental retardation [76]
Summary
De Jonge, R.C.; Van Furth, A.M.; Wassenaar, M.; Gemke, R.J.; Terwee, C.B. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies. Collaborative Research Committee of the American Academy of Pediatrics Children with Bacterial Meningitis Presenting to the Emergency Department during the Pneumococcal Conjugate Vaccine Era. Acad. S.L.; O Mason, E.; Wald, E.R.; Schutze, G.E.; Bradley, J.S.; Tan, T.Q.; Hoffman, J.A.; Givner, L.B.; Yogev, R.; Barson, W.J. Decrease of invasive pneumococcal infections in children among 8 children’s hospitals in the United States after the introduction of the 7-valent pneumococcal conjugate vaccine. E.C.; Everett, D.B.; Mukaka, M.; Bar-Zeev, N.; Feasey, N.; Jahn, A.; Moore, M.; Van Oosterhout, J.J.; Pensalo, P.; Baguimira, K.; et al Bacterial Meningitis in Malawian Adults, Adolescents, and Children during the Era of Antiretroviral Scale-up and Haemophilus influenzae Type b Vaccination, 2000–2012.
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