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Recurrent Pneumococcal Meningitis in Children: A Multicenter Case-control Study

Laura Darmaun1, Corinne Levy2,3,4,5, Marion Lagrée1,3

  • 1From the CHU Lille, Urgences pédiatriques & maladies infectieuses, Lille, France.

The Pediatric Infectious Disease Journal
|June 21, 2019
PubMed
Abstract

Insights

Recurrent pneumococcal meningitis (RPM) is rare in children, occurring in 1.5% of cases. Cerebrospinal fluid leakage is a key risk factor for recurrent meningitis in pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Neurology
  • Epidemiology

Background:

  • Pneumococcal meningitis (PM) is a significant illness with a low recurrence rate.
  • Recurrent pneumococcal meningitis (RPM) presents unique challenges in diagnosis and management.

Purpose of the Study:

  • To investigate the characteristics and risk factors associated with recurrent pneumococcal meningitis in children.
  • To compare clinical features and outcomes of children with RPM versus single episodes of PM.

Main Methods:

  • A retrospective multicenter case-control study.
  • Data from children (≤18 years) with bacterial meningitis between 2001-2015.
  • Matching RPM cases with controls experiencing a single PM episode.

Main Results:

  • 1.5% of pediatric PM episodes were recurrent (24/1634).
  • RPM cases showed less frequent winter seasonality and fewer ear, nose, and throat infections.
  • Cerebrospinal fluid leakage was significantly more common in RPM cases (83% vs. 10%).
  • No differences in mortality or neurologic outcomes were observed between groups.

Conclusions:

  • Recurrent pneumococcal meningitis is a rare but significant condition in children.
  • Cerebrospinal fluid leakage is a critical factor to consider in pediatric patients with recurrent meningitis.

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