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Published on: February 23, 2014
Pneumococcal meningitis in childhood: a longitudinal prospective study.
Pasquale Pagliano1, Ugo Fusco, Vittorio Attanasio
1Department of Emergency, I Division of Infectious Diseases, D. Cotugno Hospital, Naples, Italy. ppagliano@libero.it
FEMS Immunology and Medical Microbiology
|September 20, 2007
Summary
Pneumococcal meningitis in children often has poor outcomes, especially with penicillin-nonsusceptible strains or early intensive care unit admission. Early detection and treatment are crucial for better recovery in pediatric bacterial meningitis cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Bacterial meningitis remains a significant threat to children's health.
- Following widespread immunization against Haemophilus influenzae type b, Streptococcus pneumoniae has emerged as a leading cause of bacterial meningitis in pediatric populations.
- Understanding the factors influencing outcomes in pneumococcal meningitis is critical for improving patient care.
Purpose of the Study:
- To identify predisposing conditions, clinical manifestations, and microbiological factors associated with pneumococcal meningitis in children.
- To determine the key predictors of unfavorable outcomes, including death and neurological sequelae, in pediatric pneumococcal meningitis.
- To analyze the susceptibility patterns of Streptococcus pneumoniae strains to penicillin.
Main Methods:
- A 9-year retrospective study enrolled children with confirmed Streptococcus pneumoniae meningitis.
- Data collected included predisposing conditions, clinical and laboratory findings, microbiological studies (including antibiotic susceptibility), and imaging.
- Outcomes were categorized as favorable (complete recovery) or unfavorable (death or neurological sequelae).
Main Results:
- Of 64 pediatric patients, 48% had predisposing conditions.
- Fever and neck stiffness were common symptoms; 22% experienced seizures pre-admission.
- Penicillin-susceptible strains predominated (84%), yet 22% of patients had unfavorable outcomes, often linked to low CSF cell counts, low neutrophils, early ICU admission, or penicillin-nonsusceptible strains.
Conclusions:
- Penicillin-nonsusceptible Streptococcus pneumoniae strains and early intensive care unit (ICU) admission are significant predictors of poor outcomes in pediatric pneumococcal meningitis.
- Low cerebrospinal fluid (CSF) cell counts and low blood neutrophil counts also correlate with unfavorable prognoses.
- These findings highlight the need for vigilant monitoring and prompt intervention in high-risk pediatric patients with pneumococcal meningitis.
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