Prognosis

About 10% to 20% of children who survive bacterial meningitis develop severe complications such as sensorineural hearing loss, motor problems, seizures, and significant cognitive impairment.[58][59][60]​​[61] Around 20% to 30% of children have more subtle adverse outcomes such as academic, and behavioural problems.[62][63][64][65]

In general, infants are at higher risk of developing neurological complications following bacterial meningitis compared with older children.[66]​​[67] In one prospective study, 71% of infants aged <1 year developed neurological complications compared with 38% in children aged 1-5 years and 10% in those aged 6-16 years.[66]​

Infants aged <1 year at time of diagnosis are also at increased risk of developing hydrocephalus, subdural effusion, seizures, and hearing loss.[68] Altered level of consciousness at presentation, as well as increased duration of unconsciousness, is associated with poor prognosis.[66]​[65][69]

Neurological complications are more common in lower- and middle-income countries compared with high-income countries. This is thought to be due to delayed presentation to medical services, lack of access to health care, and limited resources in lower-income countries.[65]

Mortality

Overall, the mortality rate for bacterial meningitis in children is 4% to 10%.[70] Mortality rates vary according to the causative pathogen: 3% to 7% for Haemophilus influenzae and Streptococcus agalactiae (group B streptococcus); 20% to 25% for Streptococcus pneumoniae; and 30% to 40% for Listeria monocytogenes.[11][71] Mortality rates are higher in neonates and adolescents than in younger children.[17][72] Most deaths due to meningococcal meningitis occur in the first 24 hours of illness.[73]

Delayed antibiotic administration increases mortality.[3][74][75]

Use of this content is subject to our disclaimer