Long-term outcome of neonatal meningitis.
OBJECTIVE
To determine the long-term outcome of neonatal bacterial meningitis and the relationship between the outcome and specific features in the acute stage of the disease; and to compare the outcome between infants with neonatal meningitis and high-risk infants without meningitis.


METHODS
Prospective clinical evaluations of 21 survivors of meningitis and 21 matched controls who were retrospectively selected from a high-risk patient population.


METHODS
Program of follow-up performed at the Children and Youth Project's High Risk Center of the Department of Pediatrics, University of Louisville, Louisville, Ky. Neonates were inborn at a university hospital with a high-risk obstetric unit and level III nursery.


METHODS
Twenty-six consecutive neonates born between 1970 and 1980 with culture-proven bacterial meningitis, excluding neonates with congenital neurologic defects. Nineteen of 21 survivors and 21 controls matched by age, sex, race, birth weight, and gestational age were followed up from 1 to 14 years (mean, 7.8 years). Both survivors and controls fell below the federal poverty guidelines.


RESULTS
Gram-positive meningitis was twice as common as gram-negative meningitis with co-occurrence of meningitis and sepsis in half of the cases. Neonates with gram-positive meningitis and higher birth weight had a higher survival rate, but this finding was not statistically significant. The mortality rate in neonates with gram-negative meningitis was almost three times higher than that of neonates with gram-positive meningitis, but no significant difference was observed between their morbidity rates. Eight (38%) of 21 survivors were normal, while another eight (38%) and five (24%) had mild and moderate to severe sequelae, respectively. Survivors of meningitis had lower IQ scores and more severe sequelae than matched controls.


CONCLUSIONS
Neonatal bacterial meningitis results in poorer long-term outcome than in controls, but improved outcome compared with previous studies of neonatal meningitis.
Franco
S M
SM
Department of Pediatrics, University of Louisville, Ky.
Cornelius
V E
VE
Andrews
B F
BF
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000209:etiology*; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications* / Q000401:mortality; D011446:Prospective Studies; D013997:Time Factors; D014786:Vision Disorders / Q000209:etiology