UBC Faculty Research and Publications

Outcomes beyond hospital discharge in infants and children with viral meningitis : a systematic review Hudson, Jessica A.; Broad, Jonathan; Martin, Natalie G.; Sadarangani, Manish; Galal, Ushma; Kelly, Dominic F.; Pollard, Andrew J.; Kadambari, Seilesh


Viruses are the commonest cause of childhood meningitis, but outcomes beyond hospital discharge are poorly described. We undertook a systematic literature review of long-term outcomes following paediatric viral meningitis. A search was carried out using MEDLINE, Embase and Cochrane Review for studies from 1/1/1990 - 31/12/2018. Studies were included where specific outcome measures were available beyond hospital discharge for children <16 years old with viral meningitis. In total, 3588 papers were identified of which 14 were eligible for inclusion. Four studies reported outcomes in children with non-enterovirus 71 meningitis. A USA study of 16 cases demonstrated subtle language difficulties at three-year follow-up in infants in contrast to an Australian study which revealed no impairment in language. A Fijian study showed 2 out of 8 cases had sensorineural hearing loss compared to none in a UK cohort of 668 infants. Three studies evaluated outcomes of enterovirus 71 meningitis in China and Taiwan; two showed cases recovered without sequelae while one demonstrated an increased risk of attention deficit hyperactivity disorder. Two studies including 141 cases of human parechovirus revealed no evidence of neurodevelopmental sequelae. Conversely, an Australian study demonstrated neurodevelopmental sequelae in 11 out of 77 infants with parechovirus meningitis. Most studies identified in this review demonstrated a high proportion of good clinical outcomes following viral meningitis. However, the data are limited, so robustly conducted neurodevelopmental studies are warranted to inform the evidence-based management of viral meningitis beyond hospital discharge.

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