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Long-Term Sequelae of Pneumococcal Meningitis in Children

Department of Pediatrics, Hospital for Infectious Diseases, Thessaloniki, Greece

John Kavaliotis

Department of Pediatrics, Hospital for Infectious Diseases, Thessaloniki, Greece

John Tsikoulas

First Pediatric Department, University of Thessaloniki

Panayiotis Andrianopoulos

Kentrikon Hospital, Thessaloniki

David Venzon

Biostatistics and Data Management Section, National Cancer Institute, Bethesda, Maryland

Sotiris Manios

Department of Pediatrics, Hospital for Infectious Diseases, Thessaloniki, Greece

The purpose of this study was to assess the long-term effects of pneumococcal meningitis in children. From 1967 to 1988, a total of 90 children were admitted to the Hospital for Infectious Diseases, Thessaloniki, Greece, with the diagnosis of pneumococcal meningitis. Sixteen patients died in the hospital as a direct result of meningitis. Eleven others were excluded from the study (neurologic deficits prior to onset of meningitis, two; death subsequent to hospitalization, two; recurrent meningitis, seven). Of the remaining 63 survivors, we were able to evaluate 47 patients (75%). Evaluation was performed 4 to 23 years (mean 12.3 ± 5.8 years) after discharge. Forty patients returned to hospital for evaluation, and seven were evaluated by their primary physicians, who sent information by a standardized questionnaire. The following examinations were carried out: history, physical and neurologic examination, ophthalmologic and hearing evaluation, and psychometric testing. Fourteen patients (30%) had at least one neurologic handicap; nine (19%) had mental retardation, eight (17%) hearing loss, seven (15%) seizure disorder, five (11%) motor defects, and one each (2%) behavioral problems and visual impairment. The presence of coma was the strongest predictor of increased morbidity. The high frequency of long-term sequelae observed in our study supports the need of an effective vaccine.

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