NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
Evidence review I1
NICE Guideline, No. 240
London: National Institute for Health and Care Excellence (NICE) ; 2024 Mar . ISBN-13: 978-1-4731-5777-4 Copyright © NICE 2024. For more information, see the Bookshelf Copyright Notice.What is the risk of long-term complications in bacterial meningitis?
Bacterial meningitis is a rare but serious infection, which can occur in any age group. Despite effective therapy, a range of long-term complications can occur in children of all ages and in adults.
The aim of this review is to evaluate the risk of long-term complications following bacterial meningitis to inform patients, parents, carers and health care practitioners.
See Table 1 for a summary of the Population, Prognostic factors, Comparison and Outcome characteristics of this review.
Summary of the protocol.
For further details see the review protocol in appendix A.
This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual. Methods specific to this review question are described in the review protocol in appendix A and the methods document (supplementary document 1).
Declarations of interest were recorded according to NICE’s conflicts of interest policy.
Studies with univariate analyses were included in this review because only 3 studies (Anderson 2004, Grimwood 1995, Koomen 2003) reported multivariate analyses and did not cover all relevant age groups or report all outcomes of interest.
The included studies are summarised in Table 2.
All studies reported bacterial meningitis as potential risk factor.
See the literature search strategy in appendix B and study selection flow chart in appendix C.
Studies not included in this review are listed, and reasons for their exclusion are provided in appendix J.
Summaries of the studies that were included in this review are presented in Table 2.
Summary of included studies.
See the full evidence tables in appendix D and the forest plots in appendix E.
This section is a narrative summary of the findings of the review, as presented in the GRADE tables in appendix F. For details of the committee’s confidence in the evidence and how this affected recommendations, see The committee’s discussion and interpretation of the evidence.
The evidence was assessed as being very low quality due to high or moderate risk of bias in some of the domains of the QUIPs checklist, serious heterogeneity, the inclusion of indirect outcomes, and imprecision due to small number of events. The evidence was stratified by age; however, there was insufficient evidence to stratify according to receipt of critical care.
The evidence was seriously or very seriously imprecise, so cannot be taken as definitive evidence of presence or absence of association.
In children and adults, evidence showed a moderate association between bacterial meningitis and all-cause mortality.
In babies, bacterial meningitis was strongly associated with neuromotor disabilities or cerebral palsy.
In children, bacterial meningitis was also strongly associated with long-term motor deficits, when measured as impairments in gross motor function, fine motor function (in adjusted and unadjusted analyses), abnormal coordination, abnormal balance, dysdiadochokinesis, and inpatient admission for cerebral palsy or another paralytic syndrome. There was a moderate association between bacterial meningitis and disorders of the nervous system. There was no evidence for an association between bacterial meningitis and spasticity, or abnormal oculomotor test, or nystagmus or tremor of the hands and exaggerated knee jerks, or cerebral palsy, or use of outpatient services for cerebral palsy or another paralytic syndrome.
In neonates, bacterial meningitis was strongly associated with an increased risk of long-term cognitive deficits when measured as an intelligence quotient (IQ) less than 70. There was no evidence of an increased risk of cognitive deficit when measured as an IQ between 70 and 80.
In babies, bacterial meningitis was also strongly associated with long-term cognitive deficits when defined as learning difficulties and an IQ less than 70.
In babies, bacterial meningitis was strongly associated with poor educational achievement when measured as the number who achieved less than 4 General Certificate of Secondary Education (GCSE) exam passes, or number who repeated a grade, or number in receipt of special educational assistance.
In babies, bacterial meningitis was strongly associated with speech and/or language problems.
In children, bacterial meningitis was strongly associated with long-term cognitive deficits when measured as a full-scale IQ of less than 80 (adjusted and unadjusted analyses), a verbal IQ of less than 85, and functional limitation in terms of cognition rated by parents on the Health Utilities Index (HUI-2). There was no evidence of an increased risk of cognitive deficit when measured as full-scale IQ of less than 85 or less than 90.
In children, bacterial meningitis was strongly associated with having serious educational problems (based on parental report) in terms of speed, and concentration problems.
In children, bacterial meningitis was strongly associated with receipt of special educational assistance, being unable to read, deficient school achievement (based on parental report), and referral to a special needs school. There was a small but statistically significant association between bacterial meningitis and a lower rate of completion of high school education or obtaining a degree from college or university. There was no evidence that receiving more family help with homework, requiring remedial help such as tutoring, poor academic achievement (assessed with the Wide Range Achievement Test and Gilmore Oral Reading Test), reading or arithmetic ability below appropriate grade level, repeating a grade, vocational education, or speech difficulties, were associated with bacterial meningitis.
In adults, there was a strong association between bacterial meningitis and cognitive impairment, impaired executive function, and impaired non-verbal learning/memory. There was no evidence for an increased risk of impaired attention, impaired short-term/working memory, impaired verbal learning/memory, or impaired visuo-constructive functions associated with bacterial meningitis.
In babies, bacterial meningitis was strongly associated with long-term behavioural problems (based on parent/GP report or on the number scoring above cut-off based on the total score of the Child Behaviour Checklist [CBCL]). There was no evidence of an increased risk associated with bacterial meningitis for internalising or externalising problems (based on number scoring above cut-off on subscales of the CBCL).
In children, there was a strong association between bacterial meningitis and problems with adjustment at school (assessed using CBCL subscale). There were moderate associations between bacterial meningitis and long-term behavioural deficits when measured as the number scoring above cut-off based on total CBCL score or having serious educational problems (based on parental report) in terms of hyperactivity. There was no evidence of an increased risk associated with bacterial meningitis for the teacher-report version of the CBCL based on total behaviour score or adjustment at school (adaptive function in clinical range), or internalising or externalising problems (assessed using subscales of the CBCL).
In children, bacterial meningitis was strongly associated with psychological distress as reported by parents (scoring above cut-off on the Strengths and Difficulties Questionnaire), serious educational problems (based on parental report) in terms of depressed mood, and functional impairment in terms of emotion (assessed with HUI-2). There was no evidence of an increased risk associated with bacterial meningitis for depressive symptoms (assessed with self-report or parent-report versions of the Moods and Feelings Questionnaire), or psychological distress based on self-report. There was no evidence of an increased risk of DSM-IV ADHD symptoms (in terms of inattention, or hyperactivity-impulsiveness), or of functional impairment (scoring below cut-off for adaptive functioning on the Vineland Adaptive Behaviour Scale) associated with bacterial meningitis.
In neonates, there was a possible association between bacterial meningitis and sensorineural hearing loss (90% CI 1.14 to 150.83), however this was not statistically significant (using standard 95% CI).
In babies, there was a moderate association between bacterial meningitis and any hearing impairment.
In children, there was a strong association between bacterial meningitis and any hearing impairment. There was no evidence for an increased risk associated with bacterial meningitis of attending outpatient services for hearing problems.
In neonates, there was no evidence of an increased risk of bilateral impairment of visual acuity associated with bacterial meningitis.
In babies, bacterial meningitis was strongly associated with ocular or visual disorders.
In children, there was a strong association between bacterial meningitis and sensitivity to light. There was a moderate association between bacterial meningitis and having diseases of the eye or adnexa. There was no evidence of an increased risk associated with bacterial meningitis for impaired vision (based on parental report), abnormalities of vision (based on medical examination), having vision worse than 6/9 or N5, squints, inpatient admission rates for eye diseases, or use of outpatient services for eye diseases.
In neonates, there was no evidence of an increased risk of seizure disorder or absence seizures associated with bacterial meningitis.
In babies, bacterial meningitis was strongly associated with seizure disorders.
In children, there was a strong association between inpatient admission rates for epilepsy/seizure disorders and bacterial meningitis. There was no evidence of increased risks associated with bacterial meningitis for a diagnosis of epilepsy, or use of outpatient services for epilepsy/seizure disorders.
In adults, there was a strong association between bacterial meningitis and a diagnosis of epilepsy.
In neonates, there was no evidence of an increased risk associated with bacterial meningitis for persistent hydrocephalus requiring a shunt.
In children, there was no evidence of an increased risk of ventriculoperitoneal shunt associated with bacterial meningitis.
There were a number of outcomes in the protocol that were not reported by any studies, including disorders of consciousness and headache.
See appendix F for full GRADE tables.
A single economic search was undertaken for all topics included in the scope of this guideline, but no economic studies were identified which were applicable to this review question. See the literature search strategy in appendix B and economic study selection flow chart in appendix G.
No economic modelling was undertaken for this review because the committee agreed that other topics were higher priorities for economic evaluation. This was because this topic was an epidemiological review which does not involve a comparison of competing courses of action. Although the review could lead to recommendations for follow-up with opportunity costs it was not thought that the recommendations would substantially alter current practice and it was not anticipated that there will be the comparative effectiveness data to formulate a meaningful economic analysis.
Bacterial meningitis is associated with high rates of mortality and morbidity. All-cause mortality and disorders of consciousness were prioritised as critical outcomes for all age groups because of the severity of these outcomes. Similarly, long term motor deficits, long-term cognitive deficits, long-term behavioural deficits, long-term psychological impairment, any hearing impairment, any visual impairment, diagnosis of epilepsy and speech and language disorder were prioritised as critical outcomes in all age groups because of the potential long-term impact of these outcomes on the ability to carry out certain activities of daily life and on quality of life.
As above, moderate developmental delay, severe developmental delay and educational achievement were prioritised as critical outcomes because of the potential impact of these on daily functioning and quality of life. However, they were only included for neonates, babies, and children because they will not be relevant to people who contracted bacterial meningitis in adulthood. Headache and hydrocephalus with a shunt were also selected as critical outcomes for adults, and neonates, babies, and children, respectively, because these outcomes could impact on quality of life and were expected to be commonly reported in studies.
The quality of the evidence was assessed using GRADE methodology. The evidence for all outcomes identified in this review was very low quality, and the main reasons for downgrading the evidence were risk of bias (for example, arising from issues with study participation due to limited information about baseline characteristics, participants lost to follow-up, lack of information about prognostic factor measurement, subjective measurement of outcome, failure to adjust for confounding factors, and insufficient presentation of analytical strategy) and imprecision due to small number of events. There was also some heterogeneity that could not be explained by subgroup analysis and one instance of inclusion of an indirect outcome.
No evidence was found that reported disorders of consciousness or headache.
The committee considered the evidence for long-term complications associated with bacterial meningitis and noted that the quality of the evidence was very low for all outcomes and findings were mostly seriously or very seriously imprecise and should not be taken as definitive evidence of associations (or lack thereof). Despite this, the committee made recommendations based on the best available evidence and their knowledge and experience. The committee were aware that in neonates and adults there was an absence of evidence for some outcomes (for example, long-term motor deficits in neonates and adults; and hearing impairment in adults); however, in the absence of evidence the committee felt, based on their knowledge and experience, that it was reasonable to extrapolate from the evidence on babies and children as bacterial meningitis could have similar impacts for other ages.
The committee agreed, based on the evidence of long-term complications identified in this review, that it is important that people with bacterial meningitis should not be discharged from hospital until relevant assessments have taken place and follow up with appropriate services has been arranged so that they receive appropriate care and are not lost to follow-up. The committee were aware that assessment of some complications (for example, hearing loss) can be done in hospital whereas some complications should be assessed in the community (for example, developmental problems). The committee also acknowledged that some people would have profound complications that are apparent at discharge, but some people may not, so appropriate follow-up arrangements will depend on individual circumstances. Therefore, the committee agreed that requirements for follow-up should be identified before discharging people with bacterial meningitis from hospital, taking account of the potential for the complications identified in the evidence.
The committee discussed that information (including any plans for follow-up) needs to be shared with community teams (the GP, and if appropriate health visitor and school nurse) to best enable professionals to identify and/or manage any complications of bacterial meningitis. The committee emphasised that this information should be communicated at or before discharge to avoid any gaps in the provision of care. The committee acknowledged that in their experience people may have queries or concerns and may need support after discharge and recommended that the patient and their family members and carers are informed about their main point of contact.
Evidence showed that bacterial meningitis was strongly associated with intellectual disability in neonates, babies, and children; with poor educational attainment and/or the need for special educational assistance in babies and children; and with speech and/or language problems in babies. Based on this evidence, and their clinical knowledge and experience the committee recommended that preparation for hospital discharge should include referral to community neurodevelopmental follow-up for neonates, babies, and children.
The committee noted that there was some evidence for an association between long-term behavioural problems, including problems with adjustment at school, following bacterial meningitis in babies and children. The evidence also showed that bacterial meningitis may increase the risk of psychological distress in children. No evidence was identified for long-term psychological impairments associated with bacterial meningitis in adults. However, based on their clinical knowledge and experience, the committee agreed that bacterial meningitis can increase the risk of post-traumatic stress disorder (PTSD) and other psychological sequelae, and recommended that cognitive and psychological support needs should be considered as part of planning for discharge for people with bacterial meningitis and a referral to psychological services should be made where needs are identified.
The evidence for epilepsy as a long-term complication of bacterial meningitis was mixed. There was some evidence for an association between a diagnosis of bacterial meningitis and seizure disorders (in babies) and inpatient admission rates for epilepsy/seizure disorders (in children). However, there was no evidence of an increased risk associated with bacterial meningitis for seizures in neonates, a diagnosis of epilepsy, or use of outpatient services for epilepsy in children. In the committee’s experience, although some people may need long-term anti-epileptic drugs following meningitis, about 60 to 70% of people may not, as seizures may be a transient effect of the acute phase of illness, rather than an ongoing issue related to, for example, a diagnosis of epilepsy. Therefore, the committee were concerned about unnecessary long-term use of anti-epileptic drugs and agreed that people who are on anti-epileptic drugs during acute illness and at hospital discharge should have the requirement for such medication reviewed 3 months after hospital discharge by an appropriate specialist. The committee recommended a 3-month follow-up period based on consensus opinion that this would give sufficient time to see if seizures were a transient effect of the illness.
The evidence showed that bacterial meningitis increased the risk of long-term hearing impairments for babies and children, and a possible association was identified for neonates. As hearing loss can have a serious impact on quality of life, the committee recommended a formal audiological assessment within 4 weeks of being fit to test, ideally before discharge. The committee noted that for neonates this should be a detailed hearing test using auditory evoked brain responses rather than the newborn rapid otoacoustic emission screen. Based on their clinical knowledge and experience, the committee were aware that if cochlear implants are needed, they should be inserted within 6 months to reduce the likelihood of cochlear ossification (which would impact feasibility of cochlear implants), and this highlighted the importance of prompt hearing assessment. As the presence and degree of hearing loss needs to be established before referral for cochlear implants can be considered, any delays associated with hearing assessment would also cause delays to assessment for cochlear implants. For the same reasons, the committee agreed that once severe or profound deafness has been identified, it is important that assessment for cochlear implants happens urgently.
In addition to the actions discussed above that should occur before people are discharged from hospital, the committee agreed that people should be followed up 4 to 6 weeks after discharge to discuss any complications associated with their bacterial meningitis and to ensure appropriate referrals are made and potential complications are not missed. For neonates, babies, children and young people, this review should be undertaken by a paediatrician, whereas for adults this review should be undertaken by a hospital doctor. The committee agreed this review should cover all possible associated morbidities, specifically the results of hearing test and whether cochlear implants are needed, psychosocial problems, and neurological and developmental problems as bacterial meningitis had moderate to strong association with these complications. However, the committee acknowledged that for adults the results of hearing tests may not be available at 4 to 6 weeks after discharge as, having a cold, for example, could make someone not fit to test and then the results of their hearing test could be delayed. The committee agreed that the overall review should not be delayed if the results of hearing tests are unavailable, due to the importance of identifying and addressing any other complications early, but that the results of hearing tests should be reviewed as soon as they are available. The committee agreed that neurological and developmental problems in neonates, babies, children, and young people should be reviewed in liaison with community child development services which is in line with routine practice, and neurological problems and care needs should be reviewed in adults.
For neonates, babies, children and young people, the committee agreed that long-term monitoring is required to identify latent or evolving sequelae (for example, neurodevelopmental, sensory, psychosocial, behavioural, and educational complications). The committee agreed that babies under 12 months should be reviewed 1 year after discharge by a paediatrician to assess for the complications identified in the evidence (neurodevelopmental, sensory, and psychosocial); and community child development services should follow-up and assess babies, children, and young people for neurodevelopmental complications for at least 2 years after discharge, and refer to relevant services (for example, neurodisability services may be needed based on severity of complications) and agree follow-up as appropriate. The committee also discussed that if a child or young person develops possible neurodevelopmental complications more than 2 years after discharge, their family members or carers should get advice from their GP. Therefore, the committee included a recommendation to raise awareness of this. The committee recommended that healthcare professionals (including school nurses, health visitors, and GPs) should be alert for late-onset complications of bacterial meningitis and be aware that complications may not appear until key transition points (for example, starting nursery, primary school, or secondary school). The committee agreed that this recommendation would provide an important safety net to minimise the risk of long-term complications being missed if they occur after the recommended period for formal follow-up.
The evidence showed that bacterial meningitis can increase the risk of poor educational outcomes. The committee agreed that the impact on education may not always be apparent, as it may not necessarily be that children and younger people are underachieving, rather that they could be achieving more if they had specific support. Therefore, they recommended that family members or carers should inform their child or young person’s school about past episode of meningitis, that this may affect their learning and that they may need additional reviews of their educational outcomes and learning needs (even when there have been no known complications). Similarly, the committee agreed that people in work or education may require a phased return, and/or referral for assessments for any additional needs or adaptations (including driving) by appropriate services if complications are present.
The committee acknowledged the moderate association between bacterial meningitis and all-cause mortality in children and adults but agreed that this was not something that could be addressed directly by a recommendation. However, in their experience, it is likely that higher rates of all-cause mortality would be secondary to some of the other complications identified in this review; therefore, the recommendations made will help to address the increased risk observed.
The committee noted that the evidence was very limited for long-term complications following bacterial meningitis in neonates, with only 1 eligible study identified and this study is not recent (published in 2003). The committee discussed that quantifying the long-term complications of bacterial meningitis is important to allow appropriate counselling and follow-up of those at risk and to prioritise treatment and prevention strategies. The committee agreed to include a research recommendation to investigate the long-term outcomes after bacterial meningitis in infancy (see Appendix K).
This review question was not prioritised for economic analysis and therefore the committee made a qualitative assessment of the likely cost-effectiveness of their recommendations. The committee made a cross reference to the NICE guideline on rehabilitation after critical illness in adults (2009) to address the relief of symptoms and to restore normal functions in people who develop long-term complications of bacterial meningitis.
Given the evidence on the health and educational harms resulting from bacterial meningitis, the committee made recommendations to ensure that the relevant assessments were undertaken to ensure that appropriate care is provided to people with bacterial meningitis and that they are not lost to follow-up. The committee reasoned that this could avert downstream costs and adverse impacts on health-related quality of life and educational attainment.
The committee considered that it was cost-effective to follow-up and assess neonates, babies, children, and young people for neurological complications for at least 2 years after discharge as such complications may not be apparent before then. The committee reasoned that early recognition and management was important to mitigate health and educational harms and that follow-up to achieve this would represent a good use of NHS resources.
Some of the recommendations made by the committee relate to vigilance and awareness about the possibility of late-onset complications which may impact on health-related quality of life or education. Whilst these recommendations have a negligible resource impact the committee believed they help to promote better recognition and management of people with bacterial meningitis who do develop such late-onset complications.
No significant resource impact is anticipated from these recommendations which the committee felt are in line with current NHS practice.
This evidence review supports recommendations 1.12.1 to 1.12.4, 1.12.7 to 1.12.10, and 1.13.1 to 1.13.11, and the recommendation for research on long-term outcomes of bacterial meningitis. Other evidence supporting these recommendations can be found in evidence reviews on long-term complications and follow-up for meningococcal disease (see evidence review I2) and support for confirmed meningitis or meningococcal disease (see evidence review K4).
Anderson 2004 Anderson, V., Anderson, P., Grimwood, K. et al. (2004). Cognitive and executive function 12 years after childhood bacterial meningitis: effect of acute neurologic complications and age of onset, Journal of Pediatric Psychology 29(2), 67–81 [PubMed : 15096529 ]
Bedford 2001 Bedford, H., de Louvois, J., Halket, S. et al. (2001). Meningitis in infancy in England and Wales: follow up at age 5 years, BMJ 323(7312), 533–536 [PMC free article : PMC48156 ] [PubMed : 11546697 ]
Berg 2002 Berg, S., Trollfors, B., Hugosson, S. et al. (2002). Long-term follow-up of children with bacterial meningitis with emphasis on behavioural characteristics, European Journal of Pediatrics 161(6), 330–336 [PubMed : 12029452 ]
Christie 2011 Christie, D., Viner, R. M., Knox, K. et al. (2011). Long-term outcomes of pneumococcal meningitis in childhood and adolescence, European Journal of Pediatrics 170(8), 997–1006 [PubMed : 21246216 ]
D’Angio 1995 D’Angio, C. T., Froehlke, R. G., Plank, G. A. et al. (1995). Long-term outcome of Haemophilus influenzae meningitis in Navajo Indian children, Archives of Pediatrics & Adolescent Medicine 149(9), 1001–1008 [PubMed : 7655584 ]
de Louvois 2007 de Louvois, J., Halket, S., Harvey, D. (2007). Effect of meningitis in infancy on school-leaving examination results, Archives of Disease in Childhood 92(11), 959–962 [PMC free article : PMC2083607 ] [PubMed : 17379662 ]
Feldman 1988 Feldman, H. M. and Michaels, R. H. (1988). Academic achievement in children ten to 12 years after Haemophilus influenzae meningitis, Pediatrics 81(3), 339–344 [PubMed : 3344177 ]
Grimwood 1995 Grimwood, K., Anderson, V. A., Bond, L. et al. (1995). Adverse outcomes of bacterial meningitis in school-age survivors, Pediatrics 95(5), 646–656 [PubMed : 7536915 ]
Hoogman 2007 Hoogman, M., van de Beek, D., Weisfelt, M. et al. (2007). Cognitive outcome in adults after bacterial meningitis, Journal of Neurology, Neurosurgery & Psychiatry 78(10), 1092–1096 [PMC free article : PMC2117539 ] [PubMed : 17353256 ]
Hugosson 1997 Hugosson, S., Carlsson, E., Borg, E. et al. (1997). Audiovestibular and neuropsychological outcome of adults who had recovered from childhood bacterial meningitis, International Journal of Pediatric Otorhinolaryngology 42(2), 149–167 [PubMed : 9692625 ]
Kloek 2020 Kloek, A. T., Brouwer, M. C., Schmand, B. et al. (2020). Long-term neurologic and cognitive outcome and quality of life in adults after pneumococcal meningitis, Clinical Microbiology & Infection 26(10), 1361–1367 [PubMed : 32006689 ]
Koomen 2003 Koomen, I., Grobbee, D. E., Jennekens-Schinkel, A. et al. (2003). Parental perception of educational, behavioural and general health problems in school-age survivors of bacterial meningitis, Acta Paediatrica 92(2), 177–185 [PubMed : 12710643 ]
Moss 1982 Moss, P. D. (1982). Outcome of meningococcal group B meningitis, Archives of Disease in Childhood 57(8), 616–621 [PMC free article : PMC1627717 ] [PubMed : 7114879 ]
Pickering 2018 Pickering, L., Jennum, P., Ibsen, R. et al. (2018). Long-term health and socioeconomic consequences of childhood and adolescent onset of meningococcal meningitis, European Journal of Pediatrics 177(9), 1309–1315 [PubMed : 29923041 ]
Roed 2010a Roed, C., Engsig, F. N., Omland, L. H. et al. (2010). Long-term mortality in patients diagnosed with pneumococcal meningitis: a Danish nationwide cohort study, American Journal of Epidemiology 172(3), 309–317 [PubMed : 20573837 ]
Roed 2010b Roed, C., Omland, L. H., Engsig, F. N. et al. (2010). Long-term mortality in patients diagnosed with meningococcal [PMC free article : PMC2837384 ] [PubMed : 20300639 ]
Roed 2011 Roed, C., Engsig, F. N., Omland, L. H. et al. (2011). Long-term mortality in children diagnosed with Haemophilus influenzae meningitis: a Danish nationwide cohort study, Pediatric Infectious Disease Journal 30(8), e147–e154 [PubMed : 21487329 ]
Roed 2012 Roed, C., Engsig, F. N., Omland, L. H. et al. (2012). Long-term mortality in patients diagnosed with Listeria monocytogenes meningitis: a Danish nationwide cohort study, Journal of Infection 64(1), 34–40 disease: a Danish nationwide cohort study, PLoS ONE 5(3), e9662 [PubMed : 22036889 ]
Roed 2013 Roed, C., Omland, L. H., Skinhoj, P. et al. (2013). Educational achievement and economic self-sufficiency in adults after childhood bacterial meningitis, JAMA 309(16), 1714–1721 [PubMed : 23613076 ]
Schmidt 2006 Schmidt, H., Heimann, B., Djukic, M. et al. (2006). Neuropsychological sequelae of bacterial and viral meningitis, Brain 129(pt2), 333–345 [PubMed : 16364957 ]
Stevens 2003 Stevens, J. P., Eames, M., Kent, A. et al. (2003). Long term outcome of neonatal meningitis, Archives of Disease in Childhood Fetal & Neonatal Edition 88(3), F179–F184 [PMC free article : PMC1721546 ] [PubMed : 12719389 ]
Taylor 1990 Taylor, H. G., Mills, E. L., Ciampi, A. et al. (1990). The sequelae of Haemophilus influenzae meningitis in school-age children, New England Journal of Medicine 323(24), 1657–1663 [PubMed : 2233963 ]
Tejani 1982 Tejani, A., Dobias, B., Sambursky, J. (1982). Long-term prognosis after H. influenzae meningitis: prospective evaluation, Developmental Medicine & Child Neurology 24(3), 338–343 [PubMed : 6980152 ]
Vartzelis 2011 Vartzelis, G., Vasilopoulou, V., Katsioulis, A. et al. (2011). Functional and behavioral outcome of bacterial meningitis in school-aged survivors, Pediatrics International 53(3), 300–302 [PubMed : 21507147 ]
Zelano 2020 Zelano, J. and Westman, G. (2020). Epilepsy after brain infection in adults: a register-based population-wide study, Neurology 95(24), e3213–e3220 [PubMed : 32989110 ]
No studies were identified which were applicable to this review question.
