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Meningitis caused by streptococci other than Streptococcus pneumoniae: a retrospective clinical study

K Møller1, E H Frederiksen, J H Wandall

  • 1Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Denmark.

Scandinavian Journal of Infectious Diseases
|October 21, 1999
PubMed

Insights

Acute bacterial meningitis caused by non-pneumococcal streptococci is rare but serious. Seizures are a key indicator of adverse outcomes in these patients.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Microbiology

Background:

  • Acute bacterial meningitis (ABM) is a severe infection of the central nervous system.
  • Streptococcus pneumoniae is the most common bacterial cause of ABM.
  • Non-pneumococcal streptococcal meningitis is less common but can lead to significant morbidity and mortality.

Purpose of the Study:

  • To investigate the clinical characteristics, complications, and outcomes of ABM caused by streptococci other than Streptococcus pneumoniae.
  • To identify risk factors and predictors of adverse outcomes in this patient population.

Main Methods:

  • Retrospective review of medical records of 26 patients with non-pneumococcal streptococcal ABM admitted between 1978 and 1998.
  • Analysis of patient demographics, clinical presentation, comorbidities, causative streptococcal species, complications, and treatment outcomes.
  • Statistical analysis to identify factors associated with adverse outcomes.

Main Results:

  • The study identified 26 cases of non-pneumococcal streptococcal ABM, representing 1.9% of all ABM cases.
  • Common comorbidities included extracerebral focus (73%) and predisposing conditions (73%).
  • Complications included cerebral abscesses (5 patients) and endocarditis (5 patients). Beta-hemolytic streptococci were associated with endocarditis, while alpha/non-hemolytic strains were linked to brain abscesses.
  • Neurologic complications occurred in 42% and extraneurologic complications in 69% of patients.
  • Adverse outcomes, including death (3 patients), occurred in 38% of patients.
  • Seizure occurrence was significantly associated with adverse outcomes; other clinical features did not show significant association.

Conclusions:

  • Non-pneumococcal streptococcal ABM, though infrequent, is associated with substantial complications and adverse outcomes.
  • Patients often present with comorbid conditions and identifiable extracerebral foci.
  • The occurrence of seizures is a critical predictor of poor prognosis in these infections.
  • Further research into specific streptococcal species and their clinical impact is warranted.

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