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Pneumococcal meningitis in adults

P Kragsbjerg1, J Källman, P Olcén

  • 1Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden.

Scandinavian Journal of Infectious Diseases
|January 1, 1994
PubMed
Summary

Pneumococcal meningitis in adults caused significant mortality and morbidity. However, this study found a relatively low case fatality rate, possibly due to prompt diagnosis and treatment.

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Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Clinical Microbiology

Background:

  • Pneumococcal meningitis remains a significant cause of mortality and morbidity in adults.
  • Understanding clinical features and outcomes is crucial for effective management.
  • The 23-valent unconjugated polysaccharide vaccine is widely used for prevention.

Purpose of the Study:

  • To examine the clinical features and outcomes of adult pneumococcal meningitis.
  • To assess the incidence and case fatality rates.
  • To evaluate the antimicrobial susceptibility and serotypes of Streptococcus pneumoniae isolates.

Main Methods:

  • A retrospective study of 31 adult pneumococcal meningitis patients from 1981-1992.
  • Analysis of clinical data, including outcomes and sequelae.
  • Microbiological investigation of bacterial isolates, including serotyping and antibiotic susceptibility testing.

Main Results:

  • The incidence of adult pneumococcal meningitis was 1.0/100,000 adults/year.
  • The overall case fatality rate was 16%, increasing to 33% in patients over 70 years.
  • Sequelae, primarily otoneurologic, were observed in 29% of patients.
  • All meningitis isolates were sensitive to penicillin, and most serotypes were covered by the 23-valent vaccine.

Conclusions:

  • Pneumococcal meningitis continues to pose a substantial health burden.
  • The low case fatality rate in this study may be attributed to factors like good prior health, rapid diagnosis, penicillin sensitivity, and prompt therapy.
  • The prevalence of vaccine-serotypes suggests the vaccine's potential impact, though further studies are needed.

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