Clinical features of hearing damages caused by bacterial meningitis in children

Abstract

Objective To explore the prognosis and risk factors of the hearing damages caused by bacterial meningitis in children. Methods A systematic retrospective analysis was carryed out based on their clinical data, the brainstem auditory evoked potential (BAEP) test and follow-up evaluation in 63 pediatric patients diagnosed with bacterial meningitis from Jun. 2011 to May 2013 in Urumqi Children's Hospital. The duration from onset to the first BAEP test, CRP results, ethnics, genders, age white blood cell count, protein and glucose levels in cerebros pinal fluid(CSF) were compared between the BAEP abnormal group and BAEP normal group. Results Fifty children were detected by BAEP. The hearing damage at single or both ears with different severity were found in 22 cases, so the incidence of abnormanity was 44%. Six cases in which were suffered from auditory pathway disorders at a single ear, including 4 cases in left ears, and 2 cases in right ears, while 16 cases were in both ears. Among them, peripheral auditory pathway damages with hearing abnormalities were found in 21 cases. Central auditory pathway damage of brainstem was found only in 1 case. Sixteen cases with BAEP abnormalities were followed up in 1-6 months. Four ears of 3 cases with severe hea-ring damages were not improved and eventually became paratonic sensorineural hearing loss. There was no difference of the duration from onset to the first BAEP test, CRP results, ethnics and genders between the BAEP abnormal group and BAEP normal group (all P>0.05). However, in BAEP abnormal group, the cases of white blood cell count ≥1000×106/L (18 cases), protein≥1.5 g/L(15 cases), glucose levels≤1.0 mmol/L (11 cases), in CSF age≤1 year old (18 cases) were significantly higher those in BAEP normal group (14 cases, 9 cases, 5 cases, 14 cases, respectively)(χ2=5.14, 6.42, 5.85, 5.41, all P<0.05). Conclusions Hearing damages are common complications of the bacterial meningitis in children, and severe hearing damages may difficult to recover in the early stage. The risk factors of hearing damages caused by the bacterial meningitis in children are age, white blood cell count, protein and glucose levels in CSF. It is quite important to finish the early BAEP tests and follow up at regular intervals for bocterial meningitis in chindren. Key words: Bacterial meningitis; Brainstem auditory evoked potential; Hearing damage; Clinical features; Child