Introduction

Meningitis is a life-threatening infection which sometimes occurs as a complication to acute otitis media (AOM). It is not entirely known what percentage of bacterial meningitis is of otogenic origin. A Dutch study found that the most common agents causing community-acquired meningitis was Streptococcus pneumoniae (53%), and Neisseria meningitidis (37%), and that concurrent AOM was a risk factor for negative outcome, indicating the importance of prompt ear examination (1). A French study of children with bacterial meningitis also identified S. pneumoniae (39%) and N. meningitidis (39%) as the most important pathogens(2).
The most common sequela after bacterial meningitis is hearing loss(3). This is particularly common after pneumococcal meningitis, where as many as 30% of patients suffer from hearing loss(3). Some studies have found lower incidences (7-12%) of post-meningitis hearing loss in children compared to adults(4, 5), whereas others have reported similar incidences(6). Animal research has shown a correlation between pneumococcal concentration in the middle ear and the development of hearing loss(7), indicating that early diagnosis of concurrent AOM and subsequent myringotomy could be beneficial. Swedish meningitis guidelines include a recommendation to perform otoscopy in all patients with meningitis, and to follow up patients with audiometry.
The aim of this study was to investigate the incidence of hearing loss in patients treated for bacterial meningitis in the Swedish county of Skåne (1.4 million inhabitants), between 2000 and 2017 and to investigate risk factors for hearing loss.