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Related Experiment Videos

Pneumococcal meningitis: a clinical and laboratory study.

P Tugwell, B M Greenwood, D A Warrell

    The Quarterly Journal of Medicine
    |October 1, 1976
    PubMed
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    Pneumococcal meningitis in Nigeria disproportionately affected older children and young adults. Diagnosis was rapid with antigen detection, but high mortality persisted, linked to severe symptoms and low white blood cell counts.

    Area of Science:

    • Neurology
    • Infectious Diseases
    • Clinical Microbiology

    Background:

    • Pneumococcal meningitis is a significant cause of morbidity and mortality, particularly in developing countries.
    • Understanding the clinical presentation, diagnostic challenges, and prognostic factors is crucial for improving patient outcomes.

    Purpose of the Study:

    • To investigate the epidemiology, diagnosis, and outcomes of pneumococcal meningitis in Zaria, Nigeria.
    • To evaluate the utility of counter-current immunoelectrophoresis for rapid diagnosis.
    • To identify factors associated with mortality in pneumococcal meningitis patients.

    Main Methods:

    • A consecutive series of 42 patients with pneumococcal meningitis were studied over 18 months.
    • Counter-current immunoelectrophoresis was used to detect pneumococcal polysaccharide antigen in cerebrospinal fluid (CSF).

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  • Physiological studies were conducted in two patients; prognostic factors were analyzed.

    • Main Results:

    • The disease was most common in older children and young adults, with few predisposing conditions.
    • Counter-current immunoelectrophoresis demonstrated high sensitivity for antigen detection in CSF.
    • Mortality was 48%, associated with impaired consciousness, low CSF white cell count, and high antigen titre.

    Conclusions:

    • Pneumococcal meningitis presents a significant challenge in this region, with high mortality despite treatment.
    • Cerebral carbohydrate metabolism disturbances and vascular damage may contribute to severe brain injury.
    • Defective polymorphonuclear leukocyte function in CSF might impair treatment response.