Pediatric survivors of bacterial meningitis face years of complications

Half of all children who survive bacterial meningitis may experience long-term complications from the infection in their lifetimes, including seizure disorders, other neurologic deficits, hearing and vision loss, behavior problems, motor delay, and impaired cognitive functioning, according to a study published in Pediatrics. These new findings may bolster the recommendation for vaccination of children against the disease.

The researchers conducted a comprehensive literature review to study long-term (5 years or more of follow-up) effects of bacterial meningitis in 1,433 children aged 1 month to 18 years who had survived the disease. Data showed that 49.2% of the survivors were reported to have 1 or more long-term complications. Of 1,012 reported disorders, 78% were behavior/intellectual deficits. Specific diagnoses were: cognitive impairment, including low intelligence quotient, 45%; gross neurologic deficits, 14.3%; behavior deficits, 7.6%; hearing deficits, 6.7%; and attention-deficit/hyperactivity disorder, 2.4%.

Previous studies have followed patients for up to 5 years after initial infection or focused on particular abnormalities caused by the disease. Reporting of complications also has varied widely among researchers, making it difficult to quantify the magnitude of each disorder. The new study, the researchers say, clearly demonstrates that childhood bacterial meningitis is associated with substantial, long-term behavioral and academic limitations in survivors.

The investigators note that although some neurologic complications from an episode of bacterial meningitis resolve over time, subtle behavior or neurologic problems may not be recognized initially and may affect these children for many years. They call for further studies that will “quantify the true societal and economic burden of long-term sequelae [of bacterial meningitis] as well as fully understand the breadth of types of sequelae that survivors experience.”

Chandran A, Herbert H, Misurski D, Santosham M. Long-term sequelae of childhood bacterial meningitis: an underappreciated problem. Pediatr Infect Dis J. 2011;30(1):3-6.