Journal of Pediatric Neurology
DOI: 10.1055/s-0040-1716366
Original Article

Hearing and Neurodevelopmental Outcomes of Young Infants with Parechovirus-A and Enterovirus Meningitis: Cohort Study in Singapore Children and Literature Review

1  Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
,
Jessica Hui Yin Tan
1  Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
,
2  Department of Paediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
3  Department of Laboratory Medicine, National University Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
4  Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
4  Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
5  Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
,
4  Department of Paediatrics, Infectious Disease Service, KK Women's and Children's Hospital, Singapore, Singapore
6  Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
› Author Affiliations

Abstract

Parechovirus-A (PeV-A) and Enterovirus (EV) commonly cause childhood aseptic meningitis. Bacterial meningitis in children has been associated with devastating long-term sequelae. However, developmental outcomes are unclear in Parechovirus meningitis. This study aims to review the clinical findings and developmental outcomes of infants with PeV-A and EV meningitis. We performed a retrospective study of infants aged 90 days or younger being admitted to our hospital with PeV-A meningitis between November 2015 and July 2017, with positive cerebrospinal fluid (CSF) PeV-A PCR and negative blood and CSF bacterial cultures. Hearing and neurodevelopmental outcomes were compared with a previous cohort of infants aged 90 days or younger with EV meningitis admitted from January 2015 to December 2015. A total of 161 infants were included in our study, of which 68 infants (42.2%) had PeV-A meningitis and 93 infants (57.8%) had EV meningitis. We assessed their developmental outcome at 6 months, 1 year, and 2 years post-meningitis. At 2 years post-meningitis, three infants with PeV-A meningitis had developmental delay (5.5%), whereas none with EV meningitis had developmental delay. One patient had speech delay and autism spectrum disorder, while two had mild speech delay. When compared with our cohort of EV meningitis ≤90 days old, children with PeV-A meningitis ≤90 days old were more likely to have developmental delay 2 years post-meningitis (odds ratio 2.4, 95% confidence interval 2.0–3.0, p = 0.043). None of the patients with PeV-A or EV meningitis had sensorineural hearing loss or neurological sequelae, such as cortical blindness, oropharyngeal dysphagia, hydrocephalus, epilepsy, or cerebral palsy. Infants with PeV-A meningitis had a significant risk of developmental delay 2 years post-meningitis compared with those with EV meningitis. It is important to follow-up the developmental milestones of infants diagnosed with PeV-A meningitis for at least 2 years; and when they develop developmental delay, to ensure that they receive appropriate intervention.



Publication History

Received: 03 June 2020

Accepted: 27 July 2020

Publication Date:
16 September 2020 (online)

Georg Thieme Verlag KG
Stuttgart · New York