Table of ContentsView AllTable of ContentsCauses and Risk FactorsPathologyDiagnosisTreatmentPreventionWhen to See a Healthcare Provider
Table of ContentsView All
View All
Table of Contents
Causes and Risk Factors
Pathology
Diagnosis
Treatment
Prevention
When to See a Healthcare Provider
Hearing loss is one of the most common complications of bacterialmeningitis.Hearing loss can be temporary or permanent.
Diagnosing and treating meningitis quickly, ideally within a day or two of the appearance of symptoms, can greatly lower the risk of hearing loss. In the event hearing loss is severe or permanent, it can be managed with hearing aids, cochlear implants, and ongoing support from hearing specialists and therapists.
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The risk of hearing loss as a consequence of meningitis is greatest in children under 2, in part because they are more likely than older children or adults to experience neurological damage.
Meningitis isinflammationof the protective membranes of the brain and spinal cord called the meninges. It usually results from an infection, but in rare cases is associated with a non-infectious cause such as brain surgery orlupus.
Hearing loss is almost always associated with bacterial meningitis.Streptococcus pneumoniaeandNeisseria meningitidisare common causes of bacterial meningitis,Other bacteria, such asHaemophilus inflenzae, have also been studied in their association with menigitis-related hearing loss.
In children in high-income countries, hearing loss is seen in 14 to 32% of cases of pneumococcal meningitis and 4% of cases of meningococcal meningitis.
Studies show hearing loss rarely occurs with viral meningitis. Fungal and parasitic meningitis are even less likely causes.
As a general rule, anyone who has had bacterial meningitis should have a hearing test as soon as possible. All cases of hearing loss are different, however, and you’ll generally need repeat tests to get an accurate evaluation of your hearing.
Causes and Risk Factors of Meningitis
There are both inner and outer hair cells. Outer hair cells amplify low-level sounds. Inner hair cells transform sound vibrations into electrical signals that are relayed to the brain. Damage to these cells decreases hearing sensitivity, and, because the inner ear hair cells cannot regenerate, the damage is usually permanent.
Bacterial meningitis can also cause septicemia(“blood poisoning”), a condition that can trigger apoptosis (cell death) in the inner ear and/or auditory nerve. Hearing loss involving these organs is known as sensorineural hearing loss and is almost always permanent. Babies are especially at risk, because the organs of their ears are still developing.
Hearing Loss Causes in Adults: What to Know
If hearing is impaired during or immediately following a bout of meningitis, a healthcare provider can use a lighted scope (called an otoscope) to check for fluid that would indicate glue ear in one or both ears.
If glue ear is not the diagnosis and hearing loss is severe, persistent, or worsens, a hearing specialist, called anaudiologist, can perform a battery of tests to determine the extent of hearing loss.
Audiologist Procedures
Behavioral tests are intended for babies and younger children, but they can also be used for older children with significant hearing loss.
Auditory function tests involve devices that measure hearing sensitivity and how well organs of the ears are functioning.
Auditory function tests can be used with adults and children, although babies under 6 months may need to be sedated so they stay still during certain tests, like the ABR.
Imaging tests such asmagnetic resonance imagingorcomputed tomographymay also be performed if cochlear ossification is suspected.
Testing Recommendations
Infants and children with meningitis should have a hearing test at the time of discharge from the hospital or shortly thereafter.
Although hearing loss can be confirmed in the initial round of testing, healthcare providers cannot usually tell if the loss is permanent without routine follow-ups.
Most hearing loss can be managed with some type ofhearing aid. Options include traditional in-the-ear or behind-the-ear devices as well as frequency-modulated hearing systems (comprised of a transmitter and wireless receiver in a set of headphones or earphones).
If sensorineural hearing loss is severe enough to undermine quality of life or the ability to function normally, acochlear implantmay be considered. Not everyone is a candidate.
Other supportive options include speech and language therapy and auditory-verbal therapy, in which deaf persons learn to speak and listen with the hearing they have, often with the aid of hearing devices.
Sudden Hearing Loss in One Ear: What You Need to Know and How to Seek Help
Vaccines are available to prevent some of the most common causes of bacterial meningitis.
Hib (Haemophilus influenzaetype B) vaccineshould be given to all children younger than 5 years old.
Pneumococal vaccineshould be given to children under 5, people aged 5 to 64 with certain risk factors, and people over 65 who haven’t received the vaccine previously.
All 11- to 12-year-olds should get a single dose of themeningococcal conjugate (MenACWY) vaccinealong with a booster shot at 16. Teens and young adults 16 through 23 may also get the serogroup B meningococcal (MenB) vaccine. These vaccines are between 85% and 100% effective.
A third meningococcal vaccine (MenABCWY), which contains components of a MenACWY vaccine and a MenB vaccine, is also available. It is only recommended as an option for anyone who would otherwise be receiving both the MenACWY and MenB vaccines during the same visit.
Hearing loss may not be immediately obvious after meningitis, so it’s important to be on the lookout for signs of impairment, especially in smaller children and babies.Signs of hearing impairmentinclude the following:
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21 Sources
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Jensen ES, Cayé-Thomasen P, Bodilsen J, et al.Hearing loss in bacterial meningitis revisited-evolution and recovery.Open Forum Infect Dis. 2023;10(3):ofad056. doi:10.1093/ofid/ofad056
Zainel A, Mitchell H, Sadarangani M.Bacterial meningitis in children: neurological complications, associated risk factors, and prevention.Microorganisms. 2021;9(3):535. doi:10.3390/microorganisms9030535
Türel O, Yıldırım C, Yılmaz Y, Külekçi S, Akdaş F, Bakır M.Clinical characteristics and prognostic factors in childhood bacterial meningitis: a multicenter study.Balkan Med J. 2013;30(1):80-4. doi:10.5152/balkanmedj.2012.092
Centers for Disease Control and Prevention.Meningitis.
Persson F, Bjar N, Hermansson A, Gisselsson-Solen M.Hearing loss after bacterial meningitis, a retrospective study.Acta Otolaryngol.2022;142(3-4):298-301. doi:10.1080/00016489.2022.2058708
National Deaf Children’s Society.Meningitis.
Zeeshan F, Bari A, Dugal MN, Saeed F.Hearing impairment after acute bacterial meningitis in children.Pak J Med Sci. 2018;34(3):655-9. doi:10.12669/pjms.343.14373
Worsøe L, Cayé-Thomasen P, Brandt CT, Thomsen J, Østergaard C.Factors associated with the occurrence of hearing loss after pneumococcal meningitis.Clin Infect Dis.2010;51(8):917-24. doi:10.1086/656409
Perny M, Roccio M, Grandgirard D, Solyga M, Senn P, Leib SL.The severity of infection determines the localization of damage and extent of sensorineural hearing loss in experimental pneumococcal meningitis.J Neurosci. 2016;36(29):7740-9. doi:10.1523/JNEUROSCI.0554-16.2016
Caye-Thomasen P, Dam MS, Omland SH, Mantoni M.Cochlear ossification in patients with profound hearing loss following bacterial meningitis.Acta Otolaryngol. 2012;132(7):720-5. doi:10.3109/00016489.2012.656323
Williamson JV.An overview of the symptoms and management of glue ear.Br J School Nursing.2014 Sep;9(7):335. doi:10.12968/bjsn.2014.9.7.335
Bonino AY, Leibold LJ.Behavioral assessment of hearing in 2 to 4 year-old children: A two-interval, observer-based procedure using conditioned play-based responses.J Vis Exp. 2017;(119):54788. doi:10.3791/54788
Walker JJ, Cleveland LM, Davis JL, Seales JS.Audiometry screening and interpretation.Am Fam Physician.2013 Jan 1;87(1):41-7.
Digge P, Solanki RN, Shah DC, Vishwakarma R, Kumar S.Imaging modality of choice for pre-operative cochlear imaging: HRCT vs. MRI temporal bone.J Clin Diagn Res. 2016;10(10):TC01-TC04. doi:10.7860/JCDR/2016/18033.8592
Rodenburg-Vlot MBA, Ruytjens L, Oostenbrink R, Van der Schroeff MP.Repeated audiometry after bacterial meningitis: consequences for future management.Otol Neurotol. 2018;39(5):e301-e306. doi:10.1097/MAO.0000000000001808
Szyfter W, Karlik M, Sekula A, Harris S, Gawęcki W.Current indications for cochlear implantation in adults and children.Otolaryngol Pol.2019;73(3):1-5. doi:10.5604/01.3001.0013.1000
Centers for Disease Control and Prevention.Hib vaccination.
Centers for Disease Control and Prevention.Pneumococcal vaccination.
Centers for Disease Control and Prevention.Meningococcal vaccination.
World Health Organization.Childhood hearing loss: strategies for prevention and care.
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