https://repositorio.fleni.org.ar/xmlui/handle/123456789/604 2026-09-14T20:08:10Z 2026-09-14T20:08:10Z Alviz, Luisa F. Kim, Carla Y. Benevides Tadinac, Ana Claudia Roberts, Jackson A. Monette, Lauren E. Harrer, Caroline E. Varela, Francisco José Hwang, Soonmyung A. Gebresilassie, Blen M. Balcarce, Pilar Prasad, Manya Usseglio, John Thakur, Kiran T. https://repositorio.fleni.org.ar/xmlui/handle/123456789/1580 2026-09-08T15:40:22Z 2026-01-11T00:00:00Z

Detection of Hearing Loss by Formal Audiological Screening Test in Pediatric and Adult Acute Meningitis : A Global Systematic Review and Meta-analysis Alviz, Luisa F.; Kim, Carla Y.; Benevides Tadinac, Ana Claudia; Roberts, Jackson A.; Monette, Lauren E.; Harrer, Caroline E.; Varela, Francisco José; Hwang, Soonmyung A.; Gebresilassie, Blen M.; Balcarce, Pilar; Prasad, Manya; Usseglio, John; Thakur, Kiran T. Background Acute community-acquired bacterial meningitis remains a significant global health concern with significant mortality and morbidity, including neurological sequelae such as sensorineural hearing loss (SNHL). Early detection of meningitis-associated SNHL mitigates permanent deafness and poor outcomes. This systematic review evaluates the optimal timing of formal audiological testing in relation to the diagnosis of acute meningitis in adults and children. Methods A literature search was conducted across Ovid Medline, Elsevier Embase, and Cochrane databases. Studies reporting the time frames for hearing loss (HL) detection secondary to acute meningitis using formal audiological tests were included. Data were analyzed descriptively for continuous and categorical variables. A meta-analysis calculated the pooled prevalence of outcomes, with subgroup analyses stratified by the time frame of audiological screening. Results A total of 41 studies were included, with 8,105 meningitis patients comprising 1,397 (17.2%) adults and 6,708 (82.8%) children. In adults, most audiological screenings occurred post-discharge, yet the proportion of hearing loss diagnoses was higher before discharge than after (45.5% vs. 42.5%). Similarly, in children, more screenings were administered post-discharge compared to before (3,340 vs. 1,975), but HL diagnoses were more frequent before discharge. The pooled prevalence of HL diagnoses during hospitalization or at discharge was 30.4% (95% CI 22.9-38%), compared to 22.9% (95% CI 12.6-33.1%) within one-month post-discharge, 20.3% (95% CI 8.8-31.9%) between 30 to 60 days post discharge, 22.7% (95% CI 12.1-33.4%) between 60-180 days post-discharge, and 10.8% (95% CI 10.8-15.7%) after 180 days of discharge. Conclusion The considerable variability in the time frame of audiological test administrations following an acute meningitis episode highlights the need for standardized auditory evaluations after meningitis diagnosis. Our findings suggest that early implementation of SNHL screening, particularly before discharge, should be prioritized alongside proper follow-up screening in children and adults.

2026-01-11T00:00:00Z Schimpf, Brenda Victoria Marrodán, Mariano Hernández, Micaela Anahí Kohler, Alejandro Alfredo Fiol, Marcela Ysrraelit, María Célica Correale, Jorge https://repositorio.fleni.org.ar/xmlui/handle/123456789/1576 2026-09-07T16:28:25Z 2026-06-01T00:00:00Z

Reassessing dissemination in space : The role of spinal cord lesion burden in early multiple sclerosis diagnosis Schimpf, Brenda Victoria; Marrodán, Mariano; Hernández, Micaela Anahí; Kohler, Alejandro Alfredo; Fiol, Marcela; Ysrraelit, María Célica; Correale, Jorge Introduction: The presence of multiple spinal cord lesions has been suggested as an additional risk factor for conversion. However, their prognostic significance in the absence of brain lesions remains uncertain. Objective: To determine whether baseline spinal cord MRI features predict conversion to multiple sclerosis in patients presenting with isolated myelitis, and to compare baseline clinical, radiological, and paraclinical characteristics between converters and non-converters. Methods: A retrospective cohort study involving patients with a first episode of acute or subacute myelitis, without brain lesions at baseline MRI was conducted. All patients underwent a standardized diagnostic evaluation including brain and spinal MRI with contrast, cerebrospinal fluid analysis, and serum testing for aquaporin-4 and MOG antibodies to confirm inflammatory myelitis and exclude alternative etiologies. Clinical and paraclinical variables were analyzed. Results: We evaluated 112 patients, of whom 33% converted to MS during a median follow-up of 32.6 months. Multiple asymptomatic spinal cord lesions were associated with a higher risk of conversion to MS (HR=2.04; 95%CI:1-3.9; p = 0.03), even after adjusting for age, female sex, and the presence of gadolinium-enhancing lesions. Patients who converted to MS more frequently had cervical lesions (70% vs. 44%; p = 0.01) and were significantly younger at onset (median 34.8 vs. 42 years; p = 0.02). Conclusion: Multiple asymptomatic spinal cord lesions are associated with a higher risk of conversion to MS, supporting their value as a radiological marker of risk.

2026-06-01T00:00:00Z Camporro, Julieta Varela, Francisco Yañez, Paulina Bravo, Martín Tomatis, Antonela Mora, Andrea https://repositorio.fleni.org.ar/xmlui/handle/123456789/1552 2026-08-04T14:03:29Z 2025-09-05T00:00:00Z

Vasculitis del sistema nervioso central en pacientes inmunocompetentes con criptococosis meníngea Camporro, Julieta; Varela, Francisco; Yañez, Paulina; Bravo, Martín; Tomatis, Antonela; Mora, Andrea La criptococosis meníngea (CM) es una infección micótica grave que puede presentarse en individuos inmunocompetentes. Su diagnóstico presenta difi cultades debido a su baja frecuencia y presentación clínica variable. Las complicaciones neurológicas, como la vasculitis del sistema nervioso central (SNC) con infartos cerebrales, puede dificultar el manejo clínico. En este trabajo retrospectivo observacional, se pre sentan dos casos de CM en pacientes inmunocompeten tes que desarrollaron vasculitis del SNC. Se revisaron las historias clínicas y se describió el tratamiento instaura do y evolución clínica. Ambos pacientes fueron tratados con esteroides. El primero requirió un tratamiento prolongado con esteroides y antifúngicos debido a la recurrencia de síntomas y lesiones cerebrales. El segundo mostró me joría clínica con la administración inicial de esteroides y antifúngicos. Estos casos resaltan la importancia de considerar la CM en el diagnóstico diferencial de pacientes inmu nocompetentes, y el uso de corticoides en casos que presenten vasculitis de SNC.

2025-09-05T00:00:00Z Alviz, Luisa F. Kim, Carla Y. Monette, Lauren E. Harrer, Caroline E. Benevides Tadinac, Ana Claudia Roberts, Jackson A. Varela, Francisco José Hwang, Soonmyung A. Gebresilassie, Blen M. Balcarce, Pilar Prasad, Manya Usseglio, John Kothari, Kavita U. Venuti, Francesco Schiess, Nicoline Binello, Nicolò Brohan, Elaine Dua, Tarun Thakur, Kiran T. https://repositorio.fleni.org.ar/xmlui/handle/123456789/1508 2026-09-11T18:37:52Z 2026-02-28T00:00:00Z

Detection of sequelae from acute meningitis during clinical review by a healthcare provider: a systematic review and meta-analysis Alviz, Luisa F.; Kim, Carla Y.; Monette, Lauren E.; Harrer, Caroline E.; Benevides Tadinac, Ana Claudia; Roberts, Jackson A.; Varela, Francisco José; Hwang, Soonmyung A.; Gebresilassie, Blen M.; Balcarce, Pilar; Prasad, Manya; Usseglio, John; Kothari, Kavita U.; Venuti, Francesco; Schiess, Nicoline; Binello, Nicolò; Brohan, Elaine; Dua, Tarun; Thakur, Kiran T. Background: Neurological sequelae from acute meningitis are estimated to affect more than 30% of survivors worldwide, though often underreported or undetected due to inadequate follow-up, limited access to healthcare services, and diagnostic challenges. The aim of this systematic review and meta-analysis is to assess the time of administered health assessments for the detection of meningitis-related sequelae associated with acute meningitis diagnosis in adult and pediatric populations. Methods: A literature review was conducted in three databases. Studies documenting the time frame of sequelae detection after an acute episode of all-cause meningitis were included. Descriptive analysis and meta-analysis of pooled prevalence for neurological outcomes were performed, with subgroup analysis per timepoint of healthcare assessment. Results: A total of 89 studies met inclusion criteria, reporting 9311 adult and 18,658 pediatric meningitis cases. Among adults, 7301 (78.4%) underwent sequelae assessment, with 1339 (18%) diagnosed. The most frequently reported sequelae were hearing loss, followed by focal neurological deficits, psychological after-effects, neurocognitive impairments, seizures, hydrocephalus, speech disorders, vision impairment, and limb loss. While more were assessed before discharge (5270 vs. 2711), the proportion of sequelae diagnoses was higher post-discharge. The pooled prevalence of sequelae was 24.8% (95% CI 20.5-29.2%) at discharge, compared to 41.5% (95% CI 25.7-57.3%) within 3 months and 31.9% (95% CI 18.5-45.3%) beyond 3 months post-discharge. In children, 14,826 (79%) were assessed, and 3484 (24%) had sequelae, with the most common sequelae being hearing loss, followed by focal neurological deficits, seizures, neurocognitive, and neurodevelopmental impairments. More were assessed post-discharge (8298 vs. 7180), with a higher pooled prevalence of sequelae diagnoses post-discharge. At discharge, the pooled prevalence of sequelae was 28.9% (95% CI 20.8-37%), compared to 29.9% (95% CI 19-40.8%) within 3 months and 38.2% (95% CI 30.3-46.1%) beyond 3 months after discharge. Conclusions: Meningitis-related sequelae significantly impact quality of life. This review highlights variability and critical gaps in their evaluation, detection, and management, underscoring the need for routine monitoring from discharge through consistent follow-up assessments, as recommended by the new WHO guidelines on meningitis diagnosis, treatment, and care.

2026-02-28T00:00:00Z