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Acute otitis media and otitis media with effusion in children with bacterial meningitis

Published online by Cambridge University Press:  29 June 2007

M. P. Richardson*
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
A. Reid
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
T. J. Williamson
Department of Child Health, Royal United Hospital, Bath, Birmingham, UK.
M. J. Tarlow
Department of Paediatric Infectious Disease, Birmingham Heartlands Hospital, Birmingham, UK.
P. T. Rudd
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
Address for correspondence: Dr Martin Richardson, Paediatric Infectious Diseases Unit, Lanesborough Wing, St George's Hospital, London SW17 0QT.


Acute otitis media and otitis media with effusion (OME) have often been observed in children with bacterial meningitis. OME has also been proposed as the mechanism of reversible hearing loss after meningitis. In this controlled study, children with acute bacterial meningitis were studied using auditory brainstem responses (ABR), otoacousticemissions, tympanometry and otoscopy. An age- and sex- matched control was recruited for each patient and the incidence of acute otitis media and OME was compared between the twogroups. One hundred and twenty-four children with meningitis were studied. Ninety-two children (74 per cent) had meningococcal meningitis. Five patients (4 per cent) had conductive hearing loss (ABR threshold≥30 dB HL) at the time of discharge from hospital. None of the patients or controls had acute otitis media. Patients and controls were well matched for risk factors for OME and the prevalence of middle ear effusion in patients and controls was 7.2 per cent and 11.3 per cent respectively. The relative risk of OME in the children with meningitis was 0.64 (95 per cent confidence interval 0.29 to 1.42). After nine months, three of the five children with meningitis and conductive hearing loss had regained normal hearing.

In contrast to previous reports, there was no relationship between bacterial meningitis and acute otitis media or OME in this study. Nevertheless, coincidental conductive hearing defects were identified as the cause of reversible hearing loss in three patients.

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Copyright © JLO (1984) Limited 1997

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Crowe, S. J. (1930) Pathologic changes in meningitis of the internal ear. Archives of Otolaryngology 11: 537568.CrossRefGoogle Scholar
Djeric, D. R., Schachern, P. A., Paparella, M. M., Jaramillo, M., Haruna, S., Bassioni, M. (1994) Otitis media(silent): a potential cause of childhood meningitis. Laryngoscope 104: 14531460.Google ScholarPubMed
Dodge, P. R., Davis, H., Feigin, R. D., Holmes, S. J., Kaplan, S. L., Jubelirer, D. P., Stechenberg, B. W., Hirsh, S. K. (1984) Prospective evaluation of hearing impairment as a sequela ofacute bacterial meningitis. New England Journal of Medicine 311: 869874.CrossRefGoogle Scholar
Fortnum, H., Davis, A. (1993) Hearing impairment in children after meningitis: incidence and resource implications. British Journal of Audiology 27: 4352.CrossRefGoogle ScholarPubMed
Fortnum, H., Farnsworth, A., Davis, A. (1993) The feasibility of evoked otoacoustic emissions as an in-patient hearing check after meningitis. British Journal of Audiology 27: 227231.CrossRefGoogle ScholarPubMed
Grimwood, K., Anderson, V. A., Bond, L., Catroppa, C., Hore, R. L., Keir, E. H., Nolan, T., Roberton, D. M. (1995) Adverse outcomes from bacterial meningitis in school-age survivors. Pediatrics 95: 646656.Google ScholarPubMed
Guiscafrè, H., Benitez-Dìaz, L., Martì, M. C., Muñ, O. (1984) Reversible hearing loss after meningitis: prospective assessment using auditory evoked responses. Annals of Otology, Rhinology and Laryngology 93: 229232.CrossRefGoogle ScholarPubMed
Haggard, M., Hughes, E. (1991) Screening Children's Hearing: A Review of the Literature and the Implications of Otitis Media. HMSO, London.Google Scholar
Jeffery, H., Scott, J., Chandler, D., Dugdale, A. E. (1977) Deafness after bacterial meningitis. Archives of Disease in Childhood 52: 555559.CrossRefGoogle ScholarPubMed
Jerger, J. (1970) Clinical experience with impedance audiometry. Archives of Otolaryngology 92: 311324.CrossRefGoogle ScholarPubMed
Moss, P. D. (1982) Outcome of meningococcal group B meningitis. Archives of Disease in Childhood 57: 616621.CrossRefGoogle ScholarPubMed
Orchik, D. J., Dunn, J. W., McNutt, L. (1978) Tympanometry as a predictor of middle ear effusion. Archives of Otolaryngology 104: 46.CrossRefGoogle ScholarPubMed
Özdamar, O., Kraus, N., Stein, L. (1983) Auditory brainstem responses in infants recovering from bacterial meningitis. Archives of Otolaryngology 109: 1318.CrossRefGoogle ScholarPubMed
Quagliarello, V., Scheld, W. M. (1992) Bacterial meningitis: pathogenesis, pathophysiology and progress. New England Journal of Medicine 327: 864872.Google ScholarPubMed
Richardson, M. P., Reid, A., Tarlow, M. J., Rudd, P. T. (1997) Hearing loss during bacterial meningitis. Archives of Disease in Childhood 76: 134138.CrossRefGoogle ScholarPubMed
Richardson, M. P., Williamson, T. J., Lenton, S. W., Tarlow, M. J., Rudd, P. T. (1995) Otoacoustic emissions as a screeningtest for hearing impairment in children. Archives of Disease in Childhood 72: 294297.CrossRefGoogle Scholar
Smyth, V., O'Connell, B., Pitt, R., O'Callaghan, M., Scott, J. (1988) Audiological management in the recovery phase of bacterial meningitis. International Journal of Pediatric Otorhinolaryngology 15: 7986.CrossRefGoogle ScholarPubMed
Swartz, M. N., Dodge, P. R. (1965) Bacterial meningitis-a review of selected aspects I: general clinical features, special problems and unusual meningeal reactions mimicking bacterial meningitis. New England Journal of Medicine 272: 779787.CrossRefGoogle ScholarPubMed
Vienny, H., Despland, P. A., Lütschg, J., Deonna, T., DutoitMarco, M. L., Gander, C. (1984) Early diagnosis and evolution of deafness in childhood bacterial meningitis: a study using brainstem auditory evoked potentials. Pediatrics 73: 579586.Google ScholarPubMed
Williamson, I. G., Dunleavy, J., Bain, J., Robinson, D. (1994) The natural history of otitis media with effusion-a three- year study of the incidence and prevalence of abnormal tympanograms in four South West Hampshire Infant and First schools. Journal of Laryngology and Otology 108: 930934.CrossRefGoogle ScholarPubMed