Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis

Nayri Topalian; Amani Mansour; Saraa Wehbe; Sarah El Yaman

doi:doi:10.11648/j.ajp.20220802.26

| Peer-Reviewed

Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis

Nayri Topalian, Amani Mansour, Saraa Wehbe, Sarah El Yaman

Published in American Journal of Pediatrics (Volume 8, Issue 2)

Received: 23 May 2022 Accepted: 14 June 2022 Published: 27 June 2022

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.

Published in	American Journal of Pediatrics (Volume 8, Issue 2)
DOI	10.11648/j.ajp.20220802.26
Page(s)	141-145
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Bacterial Meningitis, Streptococcus Pneumonia, Hearing Loss, Dexamethasone, Vaccines

References

[1]	Deal A, Halliday R, Crawshaw AF, et. al. European Society of Clinical Microbiology and Infectious Diseases Study Group for Infections in Travellers and Migrants (ESGITM). Migration and outbreaks of vaccine-preventable disease in Europe: a systematic review. Lancet Infect Dis, 2021 Dec. 21 (12): e387-e398. doi: 10.1016/S1473-3099(21)00193-6. Epub 2021 Oct 6. PMID: 34626552.
[2]	Stockmann C, Ampofo K, Byington CL, et al. Pneumococcal meningitis in children: epidemiology, serotypes, and outcomes from 1997-2010 in Utah. Pediatrics, 2013. 132 (3): 421–8. doi: 10.1542/peds.2013-0621. PMID: 23979090. PMCID: PMC3876762.
[3]	Centers for Disease Control and Prevention. Pneumococcal Disease. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson, W., Wolfe, S., Hamborsky, J., McIntyre, L., eds. 13th ed. Washington DC: Public Health Foundation, 2015. (579 KB).
[4]	CDC. Pneumococcal vaccination: What everyone should know.
[5]	Nayar, A. Pneumococcal vaccine rolls out in developing world. Nature, (2011). doi.org/10.1038/news.2011.89.
[6]	According to the national vaccination card issued by Ministry of Public Health – Lebanese republic.
[7]	Aslinur Ozkaya-Parlakay, Saliha Kanik-Yuksek et. al. A refugee patient with meningococcal meningitis type B. Hum Vaccin Immunother, 2018. 14 (9): 2329. doi: 10.1080/21645515.2018.1480243. PMID: 29792550. PMCID: PMC6284475.
[8]	Cagri Dinleyici E. and Borrow R. Meningococcal infections among refugees and immigrants: silent threats of past, present and future. Hum Vaccin Immunother2020 16 (11): 2781–2786 doi.: 10.1080/21645515.2020.1744979. PMCID: PMC7746237. PMID: 32347773.
[9]	Stefanelli P, Neri A, Vacca P, et al. Meningococci of serogroup X clonal complex 181 in refugee camps, Italy. Emerg Infect Dis. 2017; 23 (5): 870–72. doi: 10.3201/eid2305.161713.
[10]	Fox JL. In children with bacterial meningitis, does the addition of dexamethasone to an antibiotic treatment regimen result in a better clinical outcome than the antibiotic regimen alone?: Part A: Evidence-based answer and summary. Paediatr Child Health. 2006;.11 (1): 33-34. doi: 10.1093/pch/11.1.33.
[11]	Brouwer MC, McIntyre P, Prasad K, van de Beek D. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev, 2015. 2015 (9): CD004405. Published 2015 Sep 12. doi: 10.1002/14651858.CD004405.pub5. PMID: 26362566. PMCID: PMC6491272.
[12]	Nakamura T, Cohen AL, Schwartz S, et al. The Global Landscape of Pediatric Bacterial Meningitis Data Reported to the World Health Organization-Coordinated Invasive Bacterial Vaccine-Preventable Disease Surveillance Network, 2014-2019. J Infect Dis, 2021 Sep 1. 224 (12 Suppl 2): S161-S173. doi: 10.1093/infdis/jiab217. PMID: 34469555. PMCID: PMC8409679.
[13]	Wahl B, O’Brien KL, Greenbaum A, et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000-15. Lancet Glob Health, 2018. 6: e744–57. doi: 10.1016/S2214-109X(18)30247-X. PMID: 29903376. PMCID: PMC6005122.
[14]	Bekiesińska-Figatowska M, Duczkowska A, Duczkowski M, et al. Pneumococcal Meningitis and Its Sequelae - A Devastating CNS Disease. J Mother Child, 2020. 24 (1): 13-18. Published 2020 Jul 29. doi: 10.34763/jmotherandchild.2020241.2010.000009. PMCID: PMC8518104. PMID: 33074177.
[15]	Kastenbauer S, Pfister HW. Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. Brain, 2003. 126 (Pt 5): 1015–25. doi: 10.1093/brain/ awg113. PMID: 12690042.
[16]	Stockmann C, Ampofo K, Byington CL, Filloux F, Hersh AL, Blaschke AJ, et al. Pneumococcal meningitis in children: epidemiology, serotypes, and outcomes from 1997-2010 in Utah. Pediatrics, 2013. 132 (3): 421–8. doi: 10.1542/peds.2013-0621. PMID: 23979090. PMCID: PMC3876762.
[17]	Sheley J, Willman D, Downen J, Bergman S. Investigation of the Selection and Timing of Pharmacological Therapy in Community-Acquired Bacterial Meningitis. P T, 2016. 41 (7): 437-441. PMID: 27408520.
[18]	Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis, 2004 Nov 1. 39 (9): 1267-84. doi: 10.1086/425368.
[19]	Bacterial meningitis: causes for concern. The Research Committee of the BSSI. J Infect, 1995 Mar. 30 (2): 89-94. PMID: 7636294.
[20]	Miner JR, Heegaard W, Mapes A, Biros MJ. Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. Emerg Med, 2001 Nov. 21 (4): 387-92. doi: 10.1016/s0736-4679(01)00407-3. PMID: 11728765.
[21]	Aronin SI, Peduzzi P, Quagliarello VJ. Community-acquired bacterial meningitis: risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med, 1998 Dec 1. 129 (11): 862-9. DOI: 10.7326/0003-4819-129-11_part_1-199812010-00004. PMID: 9867727.
[22]	Abraham E, Evans T. Corticosteroids and septic shock. JAMA, 2002. 288: 886-7. DOI: 10.1001/jama.288.7.886Fox JL. PMID: 12186608.
[23]	van de Beek D, de Gans J, McIntyre P, Prasad K. Corticosteroids in acute bacterial meningitis. Cochrane Database Syst Rev, 2003. (3): CD004305. doi: 10.1002/14651858.CD004305. Update in: Cochrane Database Syst Rev. 2007; (1): CD004405. PMID: 12918010.
[24]	Oxford Centre for Evidence-Based Medicine. Levels of Evidence and Grades of Recommendation. (Version current at December 20, 2005).
[25]	Ozen M, Kanra G, Kara A, et al. Long-term beneficial eJects of dexamethasone on intellectual and neuropsychological outcome of children with pneumococcal meningitis. Scandinavian Journal of Infectious Diseases, 2006. 38 (2): 104-9. doi: 10.1080/00365540500276005. PMID: 16449000.
[26]	Pelton S, Sadarangani M, Glennie L, Levin M. Clinical aspects of meningococcal disease. In: Feavers I, Pollard AJ, Sadarangani M, editors. Handbook of meningococcal disease management. Switzerland: Springer, 2016.
[27]	Yildirim I, Shea KM, Pelton SI. Pneumococcal disease in the era of pneumococcal conjugate vaccine. Infect Dis Clin North Am, 2015. 29: 679–697. doi: 10.1016/j.idc.2015.07.009. PMID: 26610421; PMCID: PMC466277.
[28]	McAlpine, Alastair, Sadarangani, Manish. Meningitis vaccines in children: what have we achieved and where next?, Current Opinion in Infectious Diseases, October 2019. 32 (Issue 5): 510-516 doi: 10.1097/QCO.0000000000000580. PMID: 31335439.
[29]	MacNeil JR, Blain AE, Wang X, Cohn AC. Current epidemiology and trends in meningococcal disease-United States. Clin Infect Dis, 2018. 66: 1276–1281. doi: 10.1093/cid/cix993. PMID: 29126310.
[30]	Halperin SA, Bettinger JA, Greenwood B, et al. The changing and dynamic epidemiology of meningococcal disease. Vaccine, 2012. 30 (Suppl 2): B26–B36. doi: 10.1016/j.vaccine.2011.12.032. Epub 2011 Dec 15. PMID: 22178525.
[31]	Whittaker R, Dias JG, Ramliden M, et al. The epidemiology of invasive meningococcal disease in EU/EEA countries, 2004-2014. Vaccine, 2017. 35: 2034–41. doi: 10.1016/j.vaccine.2017.03.007. Epub 2017 Mar 14. PMID: 28314560.
[32]	Government of South Australia, South Australian Meningococcal B expert working group. A meningococcal B program for South Australia public report, 2018. Available: https://www.sahealth.sa.gov.au/wps/wcm/connect/b82a9fb7-061a-48b9-be37- 54e88a1907d1/2018-06+Optimal+Men+B+Program+for+SA+Public+Report+% 282%29.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-b82a9fb7-061a-48b9- be37-54e88a1907d1-mMzmzGg.

Cite This Article

Plain Text BibTeX RIS

APA Style

Nayri Topalian, Amani Mansour, Saraa Wehbe, Sarah El Yaman. (2022). Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. American Journal of Pediatrics, 8(2), 141-145. https://doi.org/10.11648/j.ajp.20220802.26

Copy | Download

ACS Style

Nayri Topalian; Amani Mansour; Saraa Wehbe; Sarah El Yaman. Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. Am. J. Pediatr. 2022, 8(2), 141-145. doi: 10.11648/j.ajp.20220802.26

Copy | Download

AMA Style

Nayri Topalian, Amani Mansour, Saraa Wehbe, Sarah El Yaman. Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. Am J Pediatr. 2022;8(2):141-145. doi: 10.11648/j.ajp.20220802.26

Copy | Download

@article{10.11648/j.ajp.20220802.26,
  author = {Nayri Topalian and Amani Mansour and Saraa Wehbe and Sarah El Yaman},
  title = {Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {2},
  pages = {141-145},
  doi = {10.11648/j.ajp.20220802.26},
  url = {https://doi.org/10.11648/j.ajp.20220802.26},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220802.26},
  abstract = {Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis
AU  - Nayri Topalian
AU  - Amani Mansour
AU  - Saraa Wehbe
AU  - Sarah El Yaman
Y1  - 2022/06/27
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220802.26
DO  - 10.11648/j.ajp.20220802.26
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 141
EP  - 145
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220802.26
AB  - Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.
VL  - 8
IS  - 2
ER  -

Copy | Download

Author Information

Nayri Topalian

Department of General Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
Amani Mansour

Department of General Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
Saraa Wehbe

Department of General Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
Sarah El Yaman

Department of General Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Nayri Topalian, Amani Mansour, Saraa Wehbe, Sarah El Yaman. (2022). Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. American Journal of Pediatrics, 8(2), 141-145. https://doi.org/10.11648/j.ajp.20220802.26

Copy | Download

ACS Style

Nayri Topalian; Amani Mansour; Saraa Wehbe; Sarah El Yaman. Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. Am. J. Pediatr. 2022, 8(2), 141-145. doi: 10.11648/j.ajp.20220802.26

Copy | Download

AMA Style

Nayri Topalian, Amani Mansour, Saraa Wehbe, Sarah El Yaman. Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis. Am J Pediatr. 2022;8(2):141-145. doi: 10.11648/j.ajp.20220802.26

Copy | Download

@article{10.11648/j.ajp.20220802.26,
  author = {Nayri Topalian and Amani Mansour and Saraa Wehbe and Sarah El Yaman},
  title = {Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis},
  journal = {American Journal of Pediatrics},
  volume = {8},
  number = {2},
  pages = {141-145},
  doi = {10.11648/j.ajp.20220802.26},
  url = {https://doi.org/10.11648/j.ajp.20220802.26},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20220802.26},
  abstract = {Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Profound Sensorineural Hearing Loss Following Adjuvant Steroid Delay in Pediatric Bacterial Meningitis
AU  - Nayri Topalian
AU  - Amani Mansour
AU  - Saraa Wehbe
AU  - Sarah El Yaman
Y1  - 2022/06/27
PY  - 2022
N1  - https://doi.org/10.11648/j.ajp.20220802.26
DO  - 10.11648/j.ajp.20220802.26
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 141
EP  - 145
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20220802.26
AB  - Streptococcus pneumonia is a gram positive, polysaccharide-encapsulated diplococcus associated with various pulmonary and extra-pulmonary clinical presentations including invasive diseases such as acute meningitis. It can be associated with high rates of morbidity and mortality in both the pediatric and the adult populations. The introduction of the pneumococcal conjugate vaccine which expanded to cover 13 strains allowed remarkable protection against these invasive infections. In addition, the use of adjuvant corticosteroid therapy in the last few years; in particular dexamethasone, for the management of acute bacterial meningitis reduced the incidence of severe hearing loss in both Hib and other bacterial meningitis. The IDS guidelines recommend administering the first dose of steroids just before or with the start of antibiotics due to its decreased effectiveness with the late presentations of meningitis. We present the case of a 14-year-old female adolescent refugee, with incomplete vaccination status prior to relocating to Lebanon presenting with pneumococcal meningitis. Her hospitalization was complicated by bilateral profound sensorineural hearing loss (SNHL) following a delay in steroid administration. The aim of this article is to highlight the role of vaccines in decreasing morbidity of vaccine-preventable illnesses, and the importance of early administration of steroids as adjuvant to therapy for prevention of neurologic sequeleae.
VL  - 8
IS  - 2
ER  -

Copy | Download