Bacterial meningitis is a pediatric medical emergency associated with a significant risk of sensorineural hearing loss (SNHL), often with rapid onset and progression. Cochlear ossification may occur within weeks of infection, limiting the window for effective intervention, including cochlear implantation. Early, coordinated audiologic management is therefore critical to optimize outcomes in this high-risk population.
This session reviews the pathophysiology of meningitis-related hearing loss and its clinical implications for audiologic care. Emphasis is placed on the role of evidence-based practice guidelines (EBPGs) in standardizing assessment, facilitating timely intervention, and supporting interdisciplinary collaboration. A structured clinical pathway is presented, including audiology consult at admission, baseline auditory brainstem response (ABR) and otoacoustic emissions (OAE) testing once medically stable, repeat ABR within 2–4 weeks, and early magnetic resonance imaging (MRI) to evaluate cochlear patency. Ongoing audiologic surveillance and expedited referral for cochlear implant evaluation are also discussed.
A representative case of a 4-month-old infant with pneumococcal meningitis is included to illustrate rapid progression to bilateral profound SNHL, radiologic evidence of labyrinthitis ossificans, and successful bilateral cochlear implantation within six weeks of diagnosis.
Early identification and protocol-driven management are essential to prevent delays in diagnosis and intervention. EBPGs provide a critical framework for ensuring consistent, timely, and effective care, ultimately improving auditory and developmental outcomes for infants with bacterial meningitis.
Learning Objectives:
- Recognize how evidence-based clinical pathways can support consistent, timely and patient-centered care for specific populations
- Describe the relationship between bacterial meningitis and hearing loss including the importance of timely follow-up
- Apply evidence-based clinical pathway for audiologic management following bacterial meningitis
