Patient selection: pediatric patient with bacterial meningitis
Bacterial pathogens: Streptococcus pneumoniae, Neisseria meningitidis (Hemophilus influenza is uncommon in children who have been properly vaccinated).
Hearing loss was seen in almost a third of the patients and ranged from mild to severe.
Risk factors for hearing loss:
(1) meningitis due to Streptococcus pneumoniae
(2) length of hospitalization
(3) seizures
(4) development of a cranial nerve neuropathy
(5) elevated protein in the CSF
(6) decreased glucose in the CSF
where:
• The cutoff for lenght of hospitalization was not given. It was 16 days for those with hearing loss vs 12 without.
• The cutoff for a decreased glucose was not given. Those with hearing loss had values in the low to mid 20's while those without had values in the 40's. I will use < 35 mg/dL in the implementation.
• The cutoff for CSF protein was not given. Those with hearing loss had CSF proteins > 240 mg/dL. CSF protein was not a significant predictor for Neisseria meningitidis meningitis.
NOTE: As shown in table 4 (page 943) none of the factors reached statistical significance for predicting hearing loss in patients with Neisseria meningitidis meningitis.
