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Pneumococcal meningitis in the elderly.

B Barsić1, M Lisić, J Himbele

  • 1University Hospital for Infectious Diseases, Dr Fran Mihaljević, Zagreb, Croatia.

Neurologia Croatica : Glasilo Udruzenja Neurologa Jugoslavije = Official Journal of Yugoslav Neurological Association
|January 1, 1992
PubMed
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Elderly patients with pneumococcal meningitis face a higher mortality risk due to delayed hospital admission and more severe symptoms. Prompt diagnosis and treatment are crucial for improving outcomes in this vulnerable population.

Area of Science:

  • Infectious Diseases
  • Geriatric Medicine
  • Neurology

Background:

  • Streptococcus pneumoniae meningitis is a serious infection.
  • Outcomes and clinical features can vary significantly with age.

Purpose of the Study:

  • To compare clinical features, laboratory findings, and outcomes of pneumococcal meningitis in elderly versus younger patients.
  • To identify factors contributing to increased mortality in elderly individuals.

Main Methods:

  • Retrospective review of 70 cases of Streptococcus pneumoniae meningitis (1985-1989).
  • Comparison of clinical presentation, hospital admission timing, mental status, and laboratory results between elderly (>60 years) and younger (<59 years) patient groups.
  • Analysis of outcomes, including mortality rates.

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Main Results:

  • Mortality rate was significantly higher in the elderly (57%) compared to younger patients (20%).
  • Elderly patients experienced delayed hospital admission and presented with more severe neurological impairment (coma/deep stupor).
  • Lower peripheral thrombocyte counts were observed in the elderly; non-survivors had lower CSF/blood glucose ratios and higher serum bilirubin levels.

Conclusions:

  • Elderly patients with pneumococcal meningitis have an increased risk of death.
  • Delayed hospital admission and more severe initial presentation in the elderly contribute to higher case-fatality rates.
  • Earlier diagnosis and intervention are critical for improving survival in elderly patients with pneumococcal meningitis.