Palla G, Villirillo A, Ughi C, Berrettini S, Sellari Franceschini S, Ursino F
Istituto di Clinica Pediatrica, Università degli Studi, Pisa.
Minerva Pediatr. 1995 Oct;47(10):401-8.
Bacterial meningitis is an infection of the central nervous system involving quite a number of neurological sequelae the most common of which is hearing impairment. To assess the incidence of audiological deficit the authors evaluated retrospectively 20 patients, between 4 months and 11 years of age, observed at the Pediatric Clinic at the University of Pisa between 1988 and 1993. A clinical-neurological examination and a complete auditory assessment (using BAEPs and impedence audiometry) has been performed in every patient between 1 and 18 months after they left hospital. 4 children had persisting neurological sequelae, 3 patients developed sensorineural hearing loss and one child visual impairment and seizures. Haemophilus Influenzae was responsible for 2 cases of sequelae and Streptococcus Pneumoniae for the other 2 cases. The number of days of illness before hospitalization and the institution of an antibacterial treatment, persistence of fever and deviation from the normal level of consciousness and persistence of neck rigidity were not correlated with the presence of sequelae. No correlation has been found between sensorineural hearing loss and the kind of antibacterial therapy. It's advisable that every child, following bacterial meningitis, should undergo a complete and repeated audiological assessment to detect any lesser impairments and/or unilateral losses that may damage the development of speech and language in any way.
细菌性脑膜炎是一种中枢神经系统感染,会引发许多神经后遗症,其中最常见的是听力障碍。为评估听力缺陷的发生率,作者回顾性评估了1988年至1993年间在比萨大学儿科诊所观察的20例年龄在4个月至11岁之间的患者。在每位患者出院后1至18个月期间进行了临床神经学检查和全面的听力评估(使用脑干听觉诱发电位和阻抗测听法)。4名儿童有持续性神经后遗症,3例患者出现感音神经性听力损失,1名儿童有视力障碍和癫痫发作。流感嗜血杆菌导致2例后遗症,肺炎链球菌导致另外2例。住院前患病天数、抗菌治疗开始时间、发热持续时间、意识水平偏离正常以及颈部强直持续时间与后遗症的存在均无相关性。感音神经性听力损失与抗菌治疗类型之间未发现相关性。建议每名患细菌性脑膜炎后的儿童都应接受全面且重复的听力评估,以检测任何可能以任何方式损害言语和语言发育的较轻损伤和/或单侧听力损失。