Herrmann Brian W, Goff Salina H, Boguniewicz Juri, Gitomer Sarah A
Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States of America; Children's Hospital Colorado, United States of America.
University of Colorado School of Medicine, Aurora, CO, United States of America.
Am J Otolaryngol. 2024 Jan-Feb;45(1):104104. doi: 10.1016/j.amjoto.2023.104104. Epub 2023 Nov 5.
Postmeningitic hearing loss from Haemophilus influenzae (H. influenzae) is increasingly due to encapsulated serotypes other than type b (Hib) and nontypeable strains (collectively, nHiB H. influenzae). Pediatric hearing loss after nHib H. influenzae meningitis remains poorly described.
Retrospecive case series of nHiB H. influenzae meningitis cases identified from a microbiologic database at Children's Hospital Colorado from 2000 to 2020. Literature regarding nHiB H. influenzae and H. influenzae postmeningitic hearing loss was also reviewed.
Eleven cases of nHib H. influenzae meningitis (median age 15.9 months) were identified due to serotype f (36 %), serotype a (27 %), and nontypable strains (36 %). Seven (64 %) patients were male, 55 % were white and 18 % were Hispanic or Latino. Hearing loss was initially identified in 4 children (40 %), with two patients with moderate conductive hearing loss (CHL) and one child with unilateral moderate sensorineural (SNHL) hearing loss patients recovering normal hearing. One patient with bilateral profound sensorineural hearing loss and associated labyrinthitis ossificans required cochlear implantation. All children (4) with identified hearing loss were noted to have additional intracranial sequelae, which included empyema (2), sinus thrombosis (2), and seizures (2). Of patients receiving steroids, 25 % had hearing loss on initial testing, compared to 66 % of those who did not receive steroids.
nHib H. influenzae can cause both transient and permanent postmeningitic hearing loss. Steroids may offer otoprotection in nHib H. influenzae meningitis similar to Hib meningitis. Given the limited literature, further study is needed to better characterize hearing outcomes after nHib H. influenzae meningitis.
由流感嗜血杆菌（H. influenzae）引起的脑膜炎后听力损失越来越多地归因于b型（Hib）以外的包膜血清型和不可分型菌株（统称为nHiB流感嗜血杆菌）。nHib流感嗜血杆菌脑膜炎后的小儿听力损失情况仍描述甚少。
对2000年至2020年从科罗拉多州儿童医院微生物数据库中识别出的nHiB流感嗜血杆菌脑膜炎病例进行回顾性病例系列研究。还回顾了有关nHiB流感嗜血杆菌和脑膜炎后听力损失的文献。
共识别出11例nHib流感嗜血杆菌脑膜炎病例（中位年龄15.9个月），病因分别为f血清型（36%）、a血清型（27%）和不可分型菌株（36%）。7例（64%）患者为男性，55%为白人，18%为西班牙裔或拉丁裔。最初在4名儿童（40%）中发现听力损失，其中2例为中度传导性听力损失（CHL），1例为单侧中度感音神经性（SNHL）听力损失，这些患者听力恢复正常。1例双侧重度感音神经性听力损失并伴有骨化性迷路炎的患者需要进行人工耳蜗植入。所有4例已确诊听力损失的儿童均有其他颅内后遗症，包括脓胸（2例）、窦血栓形成（2例）和癫痫发作（2例）。在接受类固醇治疗的患者中，25%在初次检测时有听力损失，而未接受类固醇治疗的患者中这一比例为66%。
nHib流感嗜血杆菌可导致脑膜炎后短暂性和永久性听力损失。类固醇在nHib流感嗜血杆菌脑膜炎中可能与Hib脑膜炎一样具有耳保护作用。鉴于相关文献有限，需要进一步研究以更好地描述nHib流感嗜血杆菌脑膜炎后的听力结局。
