Related Experiment Video
Updated: Jul 11, 2026
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
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
Insights
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.
Abstract:
After implementation of programmes for active immunization against Haemophilus influenzae b, Streptococcus pneumoniae and Neisseria meningitidis became the most common agents of bacterial meningitis in childhood. Over a 9-year period, children showing clinical and laboratory findings of meningitis on the basis of their positive cultures of blood or cerebro-spinal fluid (CSF) for S. pneumoniae were enrolled. Predisposing conditions, clinical and laboratory findings, and microbiological and imaging studies were considered. Meningitis-related death or neurological sequelae defined an unfavourable outcome. Sixty-four patients met the inclusion criteria. Thirty-one (48%) children had predisposing conditions to pneumococcal meningitis. Fever and neck stiffness were the main symptoms; 14 patients (22%) reported seizures before admission. Twenty-one patients required treatment in the intensive care unit (ICU). Streptococcus pneumoniae strains were penicillin susceptible in 54 cases (84%). Forty-eight children (75%) showed complete recovery. Two patients (3%) died, and 14 (22%) had sequelae. Patients with a low CSF cell count, low neutrophils, early admission to ICU or infection by penicillin-nonsusceptible strains of S. pneumoniae had an unfavourable outcome more frequently. Low blood neutrophils, low CSF cell count, early admission to ICU and infection by penicillin-nonsusceptible strains are the main factors predicting an unfavourable outcome in children with pneumococcal meningitis.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia I: Introduction
02:20Longitudinal Research
01:26Bacterial Meningitis II: Pathophysiology
01:22Bacterial Meningitis I: Introduction
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.