Acute-phase neurologic complications of Haemophilus influenzae type b meningitis: association with developmental problems at school age.
The purposes of this study were to describe the incidence of acute-phase neurologic complications in a sample of 126 children with Haemophilus influenzae type b meningitis, and to determine if these complications were associated with higher rates of learning and behavior problems at school age. Risks were assessed by comparing rates of adverse psychoeducational outcomes in the 53 children in the sample with complications to corresponding outcome rates in the 67 children who were free of neurologic complications and who did not have abnormal electroencephalograms (EEGs) or computed tomographic (CT) scans. Comparisons were made by means of logistic regression analysis. Twenty-nine children (23% of the sample) had seizures, 16 (13%) were comatose or obtunded, 15 (12%) had sensorineural hearing loss, 8 (6%) had hemiparesis, and 7 (6%) had cranial nerve deficits other than hearing loss. Relative to children without complications, those with complications had higher rates of grade repetition and substandard performance on neuropsychological and achievement testing. Adverse outcomes, however, consisted primarily of more subtle cognitive and learning problems; only two of the children in the sample obtained prorated IQ scores below 70. Sequelae were associated with persistent neurologic deficits and bilateral hearing loss, as well as with transient symptoms including seizures, coma, and hemiparesis. While study findings argue against adverse consequences for the vast majority of children treated for this disease, the results clarify learning and behavior outcomes and indicate which children are at greatest risk.
Taylor
H G
HG
Department of Pediatrics, Case Western Reserve University School of Medicine and Rainbow Babies and Childrens Hospital, Cleveland OH 44106-6038, USA.
Schatschneider
C
C
Watters
G V
GV
Mills
E L
EL
Gold
R
R
MacDonald
N
N
Michaels
R H
RH
D000293:Adolescent; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology; D002648:Child; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology; D006429:Hemiplegia / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008583:Meningitis, Haemophilus / Q000150:complications* / Q000175:diagnosis; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome