A Retrospective Study to Investigate Sensorineural Hearing Loss in Infants after Acute Bacterial Meningitis

Description

Abstract (English)

Aim: To investigate sensorineural hearing loss in infants after acute bacterial meningitis.
Material and Methods: It was a retrospective study conducted in Department of Pediatrics, NMCH, Jamuhar,
Sasaram, Bihar, India 10 months. Fifty infants with ABM were enrolled in the study with written informed consent
from parents. Details were recorded in a pre-decided proforma. Including age, gender and detailed history
followed by complete physical examination. Lumber puncture was performed in all the children for CSF
examination. Diagnosis of ABM was considered when CSF examination showed polymorphonuclear pleocytosis,
low sugar and high protein for age and /or CSF culture positive for bacterial growth.
Results: 22(44%) had abnormal imaging (USG/CT/MRI) of Brain. Hydrocephalus being the most common
abnormal finding was seen in 11 cases. 13(26%) out of 50 children developed SNHL following acute bacterial
meningitis. SNHL was bilateral in 7(14%) and unilateral in 6(12%) cases. SNHL was mild in 3patient, moderate
in 5 patients, severe in 4 patients and only 1 patient had profound hearing loss. Patient with high value for Mean
± SD for Total nucleated cells in CSF for group I was 1675.4 ± 2318.6 while for group II it was 444.57±360.3.
CSF Total Neutrophil count had more incidence of SNHL. (P value 0.003). Mean ± SD for Protein (mg/dl) in CSF
for group I was 415.2 ± 484.1 while for group II it was 204.1 ± 210.3. Patient with higher value for CSF protein
had more SNHL. (P value 0.036). Mean ± SD for Sugar (mg/dl) in CSF for group I was 25.5± 15.8 while for
group II it was 40.3 ± 15.9. Patient with low value for CSF sugar have more SNHL. Among 9 cases with CSF
sugar less than 20, 5 developed SNHL, which was statistically significant (P value 0.03). Risk of developing
SNHL is higher in patient who have CSF sugar less than 20.
Conclusions: The present study throws light on the occurrence of sensorineural hearing loss following acute
bacterial meningitis. SHNL, which if left untreated may lead to serious handicap affecting the linguistic
performance and overall development of the child. Hence our study emphasizes the need for complete audiological
evaluation of a child recovered from meningitis. BERA is a helpful tool for screening the sensorineural hearing
loss especially in the young children and infants in whom other conventional methods may not be of much use.