TY - JOUR

T1 - Hearing Loss in Bacterial Meningitis Revisited — Evolution and Recovery

AU - Jensen, Elisa Skovgaard

AU - Cayé-Thomasen, Per

AU - Bodilsen, Jacob

AU - Nielsen, Henrik

AU - Friis-Hansen, Lennart

AU - Christensen, Thomas

AU - Christiansen, Malina

AU - Kirchmann, Malene

AU - Brandt, Christian Thomas

N1 - Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

PY - 2023

Y1 - 2023

N2 - Background. Hearing loss and deafness are well-known sequelae from bacterial meningitis (ABM) and may result in social dysfunction and learning difficulties. Yet, the timely development of hearing loss and restitution is poorly studied, especially among adults. Hearing loss was revisited using otoacoustic emissions (OAEs) to determine the occurrence, magnitude, and development of hearing loss among adults with ABM. Methods. Distortion product OAEs were measured in patients with ABM the day of admission and days 2, 3, 5–7, and 10–14 and at follow-up 30–60 days after discharge. Frequencies were categorized as low (1, 1.5, 2 kHz), mid (3, 4, 5 kHz), mid-high (6, 7, 8 kHz), and high (9, 10 kHz). Audiometry was performed on discharge and 60 days after. Results were compared with 158 healthy controls. Results. OAE was obtained in 32 patients. ABM was due to S. pneumoniae in 12 patients (38%). All patients were treated with dexamethasone. OAE emission threshold levels (ETLs) were significantly decreased upon admission and at follow-up in all frequencies compared with healthy controls. A substantial and significant decrease in ETLs was found in S. pneumoniae meningitis. Sensorineural hearing loss (SNHL) >20 dB was present in 13 of 23 (57%) at discharge and in 11 of 18 patients (61%) 60 days after discharge. Hearing recovery decreased from day 3. Conclusions. Hearing loss in ABM still affects >60% of patients despite treatment with dexamethasone. In S. pneumoniae meningitis, SNHL is profound and permanent. A window of opportunity for systemic or local treatments aiming to preserve cochlear function is proposed.

AB - Background. Hearing loss and deafness are well-known sequelae from bacterial meningitis (ABM) and may result in social dysfunction and learning difficulties. Yet, the timely development of hearing loss and restitution is poorly studied, especially among adults. Hearing loss was revisited using otoacoustic emissions (OAEs) to determine the occurrence, magnitude, and development of hearing loss among adults with ABM. Methods. Distortion product OAEs were measured in patients with ABM the day of admission and days 2, 3, 5–7, and 10–14 and at follow-up 30–60 days after discharge. Frequencies were categorized as low (1, 1.5, 2 kHz), mid (3, 4, 5 kHz), mid-high (6, 7, 8 kHz), and high (9, 10 kHz). Audiometry was performed on discharge and 60 days after. Results were compared with 158 healthy controls. Results. OAE was obtained in 32 patients. ABM was due to S. pneumoniae in 12 patients (38%). All patients were treated with dexamethasone. OAE emission threshold levels (ETLs) were significantly decreased upon admission and at follow-up in all frequencies compared with healthy controls. A substantial and significant decrease in ETLs was found in S. pneumoniae meningitis. Sensorineural hearing loss (SNHL) >20 dB was present in 13 of 23 (57%) at discharge and in 11 of 18 patients (61%) 60 days after discharge. Hearing recovery decreased from day 3. Conclusions. Hearing loss in ABM still affects >60% of patients despite treatment with dexamethasone. In S. pneumoniae meningitis, SNHL is profound and permanent. A window of opportunity for systemic or local treatments aiming to preserve cochlear function is proposed.

KW - bacterial meningitis

KW - cochlea

KW - hearing loss

KW - OAE

KW - otoacoustic emissions

U2 - 10.1093/ofid/ofad056

DO - 10.1093/ofid/ofad056

M3 - Journal article

C2 - 36879624

AN - SCOPUS:85153746761

VL - 10

JO - Open Forum Infectious Diseases

JF - Open Forum Infectious Diseases

SN - 2328-8957

IS - 3

M1 - ofad056

ER -