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Fluctuation in Hearing Thresholds During Recovery From Childhood Bacterial Meningitis

Roine, Irmeli MD, PhD*; Pelkonen, Tuula MD, PhD†‡; Cruzeiro, Manuel Leite MD; Kataja, Matti PhD§; Aarnisalo, Antti MD, PhD; Peltola, Heikki MD, PhD; Pitkäranta, Anne MD, PhD

The Pediatric Infectious Disease Journal: March 2014 - Volume 33 - Issue 3 - p 253–257
doi: 10.1097/INF.0000000000000218
Original Studies

Background: Hearing loss from childhood bacterial meningitis is believed to develop early and have little tendency for recovery. We performed serial hearing evaluations in a large number of children with bacterial meningitis in Luanda, Angola to clarify if, and how often, the result changed.

Methods: Children with confirmed bacterial meningitis and hearing evaluations on admission, day 7 of treatment and the follow-up visit formed the study group. Hearing was tested by auditory brainstem response audiometry using stimuli of 40 dB, 60 dB and 80 dB. Threshold changes are described between the composite levels of 40/60 dB and 80/>80 dB.

Results. In all, 235 ears were tested. While the ≤60 dB and ≥80 dB levels were maintained through all 3 examinations in 54% and 5% of ears, respectively, changes occurred in 41%. Deterioration from the ≤60 dB level to ≥80 dB was found in 10% of the ears transiently and in 7% permanently. Improvement from the ≥80 dB level to ≤60 dB occurred in 22% of the ears. Half of the ears with ≥80 dB impairment at the follow-up visit arrived with this finding; the others lost hearing later. Maintaining the ≤60 dB level throughout was associated with milder disease (P = 0.003), fewer convulsions (P < 0.0001) and older age (P = 0.009).

Conclusions: Almost half of the ears showed threshold changes after admission during recovery from bacterial meningitis, most frequently improvement of initially severely impaired hearing, but some normal ears or with moderate impairment became severely impaired.

Supplemental Digital Content is available in the text.

From the *University Diego Portales, Santiago, Chile; Children’s Hospital, Helsinki University Central Hospital, Helsinki University, Helsinki, Finland; Pediatric Hospital David Bernardino, Luanda, Angola; §National Institute for Health and Welfare; Department of Otorhinolaryngology, Audiology Section; and Department of Otorhinolaryngology, Helsinki University Central Hospital, Helsinki University, Helsinki, Finland.

Accepted for publication August 26, 2013.

This work was supported by grants from the Päivikki and Sakari Sohlberg Foundation, the Sigrid Jusélius Foundation, the Foundation for Pediatric Research and the daily newspaper Helsingin Sanomat, Helsinki, Finland. Heikki Peltola is a scientific consultant of the Serum Institute of India. The authors have no other funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

Address for correspondence: Irmeli Roine, Los Misioneros 2237, 7520179 Santiago, Chile. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.