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.