Pneumococcal meningitis post cochlear implantation: potential routes of infection and pathophysiology
AuthorWei, Benjamin P. C.; Shepherd, Robert K.; Robins-Browne, Roy M.; Clark, Graeme M.; O'Leary, Stephen J.
Source TitleOtolaryngology - Head and Neck Surgery
University of Melbourne Author/sWei, Benjamin; Clark, Graeme; O'Leary, Stephen; Shepherd, Robert; Robins-Browne, Roy
Document TypeJournal Article
CitationsWei, B. P. C., Shepherd, R. K., Robins-Browne, R. M., Clark, G. M., & O'Leary, S. J. (2010). Pneumococcal meningitis post cochlear implantation: potential routes of infection and pathophysiology. Otolaryngology - Head and Neck Surgery, 143(5,s3), S15-S23.
Access StatusOpen Access
© 2010 American Academy of Otolaryngology–Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
Objectives: This review describes the current concept of pneumococcal meningitis in cochlear implant recipients based on recent laboratory studies. It examines possible routes of S. pneumoniae infection to the meninges in cochlear implant recipients. It also provides insights into fundamental questions concerning the pathophysiology of pneumococcal meningitis in implant recipients. Data Sources: Medline search on topics related to pneumococcal meningitis post cochlear implantation. Review Methods: Comprehensive analysis of the published clinical and scientific laboratory research data. Results: The incidence of pneumococcal meningitis in cochlear implant recipients is greater than that of an age-matched cohort in the general population. Based on the current clinical literature, it is difficult to determine whether cochlear implantation per se increases the risk of meningitis in subjects with no existing risk factors for acquiring the disease. As this question cannot be answered in humans, the study of implant-related infection must involve the use of laboratory animals in order for the research findings to be applicable to a clinical situation. The laboratory research demonstrated the routes of infection and the effects of the cochlear implant in lowering the threshold for pneumococcal meningitis. Conclusion: The laboratory data complements the existing clinical data on the risk of pneumococcal meningitis post cochlear implantation.
Keywordscochlear implants; meningitis; Streptococcus pneumoniae; routes of infection; threshold model
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