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The Children's Hospital Experience

Audie L. Woolley, MD; Katharine A. Kirk, PhD; Alfred M. Neumann, Jr, MD; Sean M. McWilliams, MS; Judy Murray, CRNP; Deborah Freind, MSc; Brian J. Wiatrak, MD

Arch Otolaryngol Head Neck Surg. 1999;125:509-514.

Objectives  To identify statistically significant risk factors for hearing loss in children with meningitis, determine the overall incidence of hearing loss in a large group of children with confirmed meningitis, and quantify the percentage of children with progressive or fluctuating hearing loss after meningitis.

Design  Retrospective analysis.

Patients and Other Participants  Four hundred thirty-two children admitted to the Children's Hospital, Birmingham, Ala, from January 1, 1985, to December 31, 1995, with the diagnosis of meningitis.

Results  Of 432 children with meningitis, 59 (13.7%) had the development of hearing loss. Of these 59 children, 46 (78.0%) had stable sensorineural hearing loss and 13 (22.0%) had either progressive or fluctuating hearing loss. Of the variables examined using multiple logistic regression backward-elimination modeling, only 5 appeared to be significantly associated with the development of hearing loss: computed tomographic scan evidence of increased intracranial pressure (estimated odds ratio [OR]=2.3), male sex (OR=1.9), the common logarithm of glucose levels in the cerebrospinal fluid (OR=0.58), Streptococcus pneumoniae as the causative organism (OR=2.1), and the presence of nuchal rigidity (OR=1.9). In the children with progressive hearing loss, the time for progression varied from 3 months to 4 years before hearing stabilized.

Conclusions  In this study of children diagnosed as having meningitis, hearing loss developed in 59 (13.7%). Forty-six (78.0%) of these children with hearing loss had stable auditory thresholds over time, and 13 (22.0%) exhibited deterioration or fluctuation of acuity over time. Evidence of increased intracranial pressure by computed tomographic scan, male sex, low glucose levels in the patients' cerebrospinal fluid, S pneumoniae as the causative organism, and the presence of nuchal rigidity appear to be significant predictors for future hearing loss.

From the Division of Pediatric Otolaryngology–Head and Neck Surgery, Department of Surgery (Drs Woolley, Neumann, and Murray, Messers McWilliams, and Ms Murray, Wiatrak), and the Charity League Hearing and Speech Center for Children (Ms Freind), Children's Hospital, The University of Alabama at Birmingham; and Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham School of Medicine (Dr Kirk).

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