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Updated: Feb 5, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
ASSOCIATION OF MENINGITIS AND PERICARDITIS IN INVASIVE PNEUMOCOCCAL DISEASE: A RARE CASE
Tiago Henrique de Souza1, José Antônio Nadal1, Carlos Eduardo Lopes1
1Universidade Estadual de Campinas, Campinas, SP, Brasil.
Insights
This case report details a rare instance of invasive pneumococcal disease in an infant, leading to meningitis and pericarditis. Early diagnosis and treatment are crucial for survival in such uncommon presentations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality in children.
- Purulent pericarditis is a rare complication of IPD, particularly since the widespread use of antibiotics.
- Pneumococcal meningitis, while serious, is more common than the combined presentation with pericarditis.
Observation:
- A previously healthy 6-month-old infant presented with fever and respiratory issues.
- Clinical evaluation revealed pericardial effusion, seizures, and coma, with Streptococcus pneumoniae identified in cerebrospinal fluid and blood cultures.
- Despite exclusion of pneumonia, the infant was declared brain dead, highlighting a rapid and unfavorable clinical course.
Findings:
- The study highlights an uncommon association between pneumococcal meningitis and purulent pericarditis in an infant.
- Streptococcus pneumoniae was confirmed as the causative agent through blood and cerebrospinal fluid cultures.
- The case underscores the diagnostic challenges and high mortality associated with this rare IPD complication.
Implications:
- Increased diagnostic suspicion for concurrent meningitis and pericarditis in IPD cases is warranted.
- Prompt and aggressive treatment strategies are essential to improve survival rates in such rare presentations.
- This case emphasizes the need for continued vigilance and research into managing severe IPD complications in pediatric populations.
Objective:
To report a rare case of a child with invasive pneumococcal disease that presented meningitis associated with pericarditis.
Case Description:
This report describes the unfavorable clinical course of a previously healthy 6-months-old female infant who initially presented symptoms of fever and respiratory problems. A chest X-ray revealed an increased cardiac area with no radiographic changes in the lungs. After identifying a pericardial effusion, the patient experienced seizures and went into coma. Pneumonia was excluded as a possibility during the clinical investigation. However, Streptococcus pneumoniae was identified in the cerebrospinal fluid and blood cultures. An initial neurological examination showed that the patient was brain dead, which was then later confirmed according to protocol.
Comments:
Purulent pericarditis has become a rare complication of invasive pneumococcal disease since the advent of antibiotic therapy. Patients with extensive pneumonia are primarily predisposed and, even with early and adequate treatment, are prone to high mortality rates. The association of pneumococcal meningitis and pericarditis is uncommon, and therefore difficult to diagnose. As such, diagnostic suspicion must be high in order to institute early treatment and increase survival.
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