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Acute otitis media and otitis media with effusion in children with bacterial meningitis

Published online by Cambridge University Press:  29 June 2007

M. P. Richardson ,
A. Reid ,
T. J. Williamson ,
M. J. Tarlow  and
P. T. Rudd
M. P. Richardson*
Affiliation:
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
A. Reid
Affiliation:
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
T. J. Williamson
Affiliation:
Department of Child Health, Royal United Hospital, Bath, Birmingham, UK.
M. J. Tarlow
Affiliation:
Department of Paediatric Infectious Disease, Birmingham Heartlands Hospital, Birmingham, UK.
P. T. Rudd
Affiliation:
Bath Unit for Research into Paediatrics, Department of Audiology, Royal United Hospital, Bath, Birmingham, UK.
*
Address for correspondence: Dr Martin Richardson, Paediatric Infectious Diseases Unit, Lanesborough Wing, St George's Hospital, London SW17 0QT.
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Abstract

Acute otitis media and otitis media with effusion (OME) have often been observed in children with bacterial meningitis. OME has also been proposed as the mechanism of reversible hearing loss after meningitis. In this controlled study, children with acute bacterial meningitis were studied using auditory brainstem responses (ABR), otoacousticemissions, tympanometry and otoscopy. An age- and sex- matched control was recruited for each patient and the incidence of acute otitis media and OME was compared between the twogroups. One hundred and twenty-four children with meningitis were studied. Ninety-two children (74 per cent) had meningococcal meningitis. Five patients (4 per cent) had conductive hearing loss (ABR threshold≥30 dB HL) at the time of discharge from hospital. None of the patients or controls had acute otitis media. Patients and controls were well matched for risk factors for OME and the prevalence of middle ear effusion in patients and controls was 7.2 per cent and 11.3 per cent respectively. The relative risk of OME in the children with meningitis was 0.64 (95 per cent confidence interval 0.29 to 1.42). After nine months, three of the five children with meningitis and conductive hearing loss had regained normal hearing.

In contrast to previous reports, there was no relationship between bacterial meningitis and acute otitis media or OME in this study. Nevertheless, coincidental conductive hearing defects were identified as the cause of reversible hearing loss in three patients.

Keywords

MeningitisbacterialOtitis mediasuppurativeOtitis media with effusionHearing lossconductive
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 10 , October 1997 , pp. 913 - 916
Copyright
Copyright © JLO (1984) Limited 1997

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