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Long-term Outcome of Neonatal Meningitis
Sofia M. Franco, MD;
Victoria E. Cornelius, MD;
Billy F. Andrews, MD
Am J Dis Child. 1992;146(5):567-571.
Abstract
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•Objective.
—To determine the long-term outcome of neonatal bacterial meningitis and the relationship between the outcome and specific features in the acute stage of the disease; and to compare the outcome between infants with neonatal meningitis and high-risk infants without meningitis.
Design.
—Prospective clinical evaluations of 21 survivors of meningitis and 21 matched controls who were retrospectively selected from a high-risk patient population.
Setting.
—Program of follow-up performed at the Children and Youth Project's High Risk Center of the Department of Pediatrics, University of Louisville, Louisville, Ky. Neonates were inborn at a university hospital with a high-risk obstetric unit and level III nursery.
Patients.
—Twenty-six consecutive neonates born between 1970 and 1980 with culture-proven bacterial meningitis, excluding neonates with congenital neurologic defects. Nineteen of 21 survivors and 21 controls matched by age, sex, race, birth weight, and gestational age were followed up from 1 to 14 years (mean, 7.8 years). Both survivors and controls fell below the federal poverty guidelines.
Results.
—Gram-positive meningitis was twice as common as gram-negative meningitis with co-occurrence of meningitis and sepsis in half of the cases. Neonates with gram-positive meningitis and higher birth weight had a higher survival rate, but this finding was not statistically significant. The mortality rate in neonates with gram-negative meningitis was almost three times higher than that of neonates with gram-positive meningitis, but no significant difference was observed between their morbidity rates. Eight (38%) of 21 survivors were normal, while another eight (38%) and five (24%) had mild and moderate to severe sequelae, respectively. Survivors of meningitis had lower IQ scores and more severe sequelae than matched controls.
Conclusion.
—Neonatal bacterial meningitis results in poorer long-term outcome than in controls, but improved outcome compared with previous studies of neonatal meningitis.
(AJDC. 1992;146:567-571)
Author Affiliations
From the Department of Pediatrics (Drs Franco, Cornelius, and Andrews), University of Louisville, Ky.
Footnotes
Accepted for publication November 13, 1991.
Reprint requests to Children and Youth Project, Department of Pediatrics, School of Medicine, University of Louisville, Louisville, KY 40292 (Dr Franco).
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