In case of hearing loss after meningitis, rapid cochlear implantation is crucial!

Meningitis refers to the inflammation of the membranes (meninges) that surround the central nervous system in the brain ("meninges") and spinal cord ("spinal meninges"). It can have many different causes—bacteria, viruses, fungi, or it can be a complication of other illnesses—and often progresses rapidly and dangerously in acute cases. [1]

Depending on the cause and the general health of the affected person, meningitis can become life-threatening. That’s why it’s crucial to consult a doctor or hospital immediately at the first signs of meningitis. Even then, lasting neurological damage can occur, including hearing loss or even complete deafness.

While other neurological consequences are difficult or impossible to rehabilitate, cochlear implants can restore hearing to a deafened ear. Since meningitis often leads to ossification (hardening) of the cochlea, the decision to implant must be made quickly. People who became deaf after meningitis and opted for an implant report very good hearing and communication outcomes.

Meningitis: many causes possible

In our region, the so-called early summer meningoencephalitis (FSME), transmitted by ticks, is often discussed in the media. Lyme disease, also tick-borne, can also lead to meningitis. While there is a protective vaccine against FSME, there is currently none for Lyme disease.

Beyond these examples, meningitis can be caused by many other pathogens: bacteria, fungi, and viruses. Vaccines exist for bacterial meningitis caused by meningococci, pneumococci, and Haemophilus influenzae type B (HiB). Many childhood illnesses can also lead to meningitis.

For example, the varicella-zoster virus (VZV), also known as human herpesvirus 3 (HHV-3), causes chickenpox. Highly contagious even two days before symptoms appear, chickenpox can also lead to meningitis. There are effective vaccines against chickenpox and mumps—another potential cause of meningitis—but not yet for many other meningitis-causing viruses.

Protection against meningitis

Given the wide range of possible causes, the World Health Organization (WHO) considers bacterial meningitis the greatest global burden. It is highly contagious, frequently causes epidemics, and is therefore a notifiable disease in Austria. The bacteria responsible are also linked to other diseases. The most important ones are meningococci, pneumococci, Haemophilus influenzae (not related to the flu), and group B streptococci.

There are effective vaccines against some of these pathogens. These vaccines protect not only the vaccinated individuals but also others who cannot be vaccinated—such as infants too young for vaccination or elderly and ill people with weakened immune systems. This is especially important for close family members.

If at least 19 out of 20 people are vaccinated, the entire population is protected. Polio is an example of a disease considered eradicated in Austria thanks to this so-called herd immunity. The WHO aims to “defeat meningitis by 2030” in a similar way.

Open wounds from surgery or injury can temporarily allow bacteria to enter the body. In the past, pneumococci have occasionally been identified as a cause of meningitis in connection with cochlear implants. However, vaccination can eliminate this risk. Additionally, atraumatic CI electrodes, such as those used by MED-EL, may further reduce potential risks.

Urgent Action Saves Lives

Petra Trieb on her CI care after meningitis: "To never hear again was unimaginable for me: I immediately said yes to the implantation." ©privat

Neck stiffness, fever, confusion, headache, and nausea and vomiting are common symptoms of meningitis. Other clinical features may vary depending on the cause and course of the disorder. If meningitis is suspected, call emergency services immediately. Bacterial meningitis is a medical emergency and can be fatal — especially in young children, who may show subtle or atypical signs.

The condition is particularly critical in babies because they are not only less resistant but also have less typical symptoms, making their critical condition easier to miss.

Even when treatment is successful, complications may remain. Take the story of Petra Trieb, a Styrian woman who lost her hearing at age 13 due to pneumococcal meningitis: “It was a major crisis: I went from being a healthy girl to deaf. The idea of hearing again was unimaginable to me.” Thanks to a cochlear implant, Petra regained her hearing: “Now I can hear everything: I understand my children, listen to music, watch TV, go to the cinema, and talk on the phone.”

But her story also highlights the importance of acting quickly: cochlear ossification can occur within weeks or months after meningitis, and delayed treatment may mean the CI electrode can no longer be fully inserted. For Petra, the decision was easy:“I couldn’t imagine never hearing again — I said yes to the implant immediately.”

[1] https://www.gesundheit.gv.at/krankheiten/gehirn-nerven/meningitis.html