Bacterial meningitis in children: Neurologic complications
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
- Section Editors
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
- Douglas R Nordli, Jr, MD
Douglas R Nordli, Jr, MD
- Section Editor — Pediatric Neurology
- Chief of Neurology
- Children’s Hospital Los Angeles
- Vice Chair of Neurology
- USC Keck School of Medicine
Bacterial meningitis continues to result in substantial morbidity and mortality despite the availability of effective antimicrobial therapy. The risk of dying or of developing complications is related to the age and underlying condition of the patient, the causative pathogen, the severity and duration of illness at the time of presentation, and, occasionally, to delays in the initiation of antibiotic therapy. (See "Bacterial meningitis in children older than one month: Treatment and prognosis".)
The neurologic complications of bacterial meningitis in children will be discussed here. The neurologic complications of bacterial meningitis in neonates and adults, and the prevention of neurologic complications in children, are discussed separately. (See "Bacterial meningitis in the neonate: Neurologic complications" and "Neurologic complications of bacterial meningitis in adults" and "Bacterial meningitis in children: Dexamethasone and other measures to prevent neurologic complications".)
Complications of bacterial meningitis can be divided into systemic and neurologic. Systemic complications, such as septic shock, disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), and septic or reactive arthritis are usually the consequence of the bacteremia that frequently accompanies meningitis. (See "Bacterial meningitis in children older than one month: Clinical features and diagnosis", section on 'Complications'.)
The neurologic complications of meningitis may be sudden or gradual in onset and can appear at any time after the onset of symptoms, including after the completion of therapy. Although many neurologic complications are severe and readily apparent, others, such as hearing loss, may be subtle or inapparent during the early phases of infection. The neurologic complications of meningitis include:
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- Prediction of risk
- ALTERED MENTAL STATUS
- INCREASED INTRACRANIAL PRESSURE
- Cerebral edema
- FOCAL DEFICITS
- Hearing loss
- Cranial nerve palsy
- CEREBROVASCULAR COMPLICATIONS
- NEUROPSYCHOLOGIC IMPAIRMENT
- Cognitive impairment
- Other sequelae
- SUBDURAL EFFUSIONS
- UNUSUAL COMPLICATIONS
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS