Recurrent meningitis in the pediatric patient--the otolaryngologist's role.
OBJECTIVE
To assess the etiology of recurrent meningitis in the pediatric patient.


METHODS
Retrospective case series and literature review.


METHODS
Tertiary-care pediatric hospital.


METHODS
Children (< 17-years-old) with recurrent meningitis, treated at Texas Children's Hospital (TCH) between 1984 and 1995.


RESULTS
A review of 463 cases of bacterial meningitis over an 11 year period revealed six children aged 3 months to 15 years with the diagnosis of recurrent meningitis. The patient's age, number of episodes of meningitis, diagnostic investigations performed and etiologies of recurrent meningitis were recorded. Fifteen episodes of meningitis were identified in these six patients; Streptococcus pneumoniae represented the bacteriology in 73% of the cases. Two patients were diagnosed with temporal bone abnormalities, two children with immunological deficiencies and no underlying etiology for the recurrent meningitis was identified in the remaining two patients. In this series, one-third of patients had an otolaryngologic etiology for their recurrent meningitis. These six patients, along with a review of the recent literature, will highlight the need for otolaryngological assessment and the importance of considering immunological investigations when managing recurrent meningitis in the pediatric patient.


CONCLUSIONS
We propose that children with recurrent meningitis of unknown etiology undergo: (1) an audiological evaluation; (2) a CT scan of the temporal bones, skull base and paranasal sinuses; and (3) an immunological evaluation.
Baylor College of Medicine, Texas Children's Hospital, Houston, USA.
D S
DS
Drummond
A L
AL
de Jong
C
C
Giannoni
M
M
Sulek
E M
EM
Friedman
D001299:Audiometry; D001921:Brain / Q000000981:diagnostic imaging; D002558:Cerebrospinal Fluid Otorrhea / Q000150:complications; D002648:Child; D005260:Female; D006192:Haemophilus Infections / Q000134:cerebrospinal fluid / Q000150:complications; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D010036:Otolaryngology; D010819:Physician's Role; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013129:Spinal Puncture; D013290:Streptococcal Infections / Q000134:cerebrospinal fluid / Q000150:complications; D014057:Tomography, X-Ray Computed