The neurologic, psychological, and educational outcomes of bacterial meningitis in 130 children evaluated at a mean age of 8 years, and 6 years after their meningitis, are reported from the Department of Paediatrics and Clinical Epidemiology and Biostatistics Unit, University of Melbourne, and the Royal Children’s Hospital, Victoria, Australia. Compared to controls, children with meningitis as a group were at greater risk (26.9%) for abnormal neurologic and audiologic sequelae, had lower IQs and neuropsychologic performance, and behavior and adaptive difficulties at school. Eleven (8.5%) had major deficits (IQ <70, seizures, hydrocephalus, spasticity, blindness, or severe to profound hearing loss); and 24 (18.5%) patients compared to 14 (10.8%) controls had minor deficits (IQ 70-80, inability to read, some hearing loss, speech problems, and behavior disorders). Those who suffered acute neurologic symptoms with the meningitis had a poorer outcome than those with uncomplicated meningitis or controls (39% vs 18% vs 11%). 
COMMENT. Even with optimal treatment, one in four children who recover from meningitis may have severe or functionally significant disabilities which affect academic performance. The poor outcome is not restricted to those having acute neurologic complications. All children recovering from meningitis should be followed carefully until school age to exclude learning, hearing, and neurologic disorders that may require treatment.