Late-Onset Profound Hearing Loss Requiring Cochlear Implantation Ten Years after Acute Bacterial Meningitis: A Case Report

Abstract Sensorineural hearing loss (SNHL) is the most common sequela of acute bacterial meningitis, typically appearing during or shortly after the acute phase. However, delayed-onset or progressive SNHL years later is exceptionally rare and often underestimated in clinical practice. We present an 8-year-old boy who developed moderate right-sided SNHL four years after acute bacterial meningitis. Initial MRI during the acute illness was normal, but a follow-up MRI revealed obliteration of the right membranous labyrinth without cochlear ossification. The patient initially benefited from a hearing aid, remaining stable for four years. At age 12, he experienced progressive deterioration, culminating in profound hearing loss and subsequent cochlear implantation, with excellent postoperative outcomes. This case highlights the rare occurrence of delayed, progressive SNHL after meningitis and underscores the importance of long-term, adaptive audiological follow-up in pediatric patients to ensure timely detection and intervention.