Pneumococcal meningitis is a bacterial inflammation or infection of the membranes covering the brain and spinal cord.
Causes, incidence, and risk factors:
Pneumococcal meningitis is caused by the bacteria Streptococcus pneumoniae (also called pneumococcus). The bacteria is the most common cause of meningitis in adults, and the second most common cause of meningitis in children older than age 6.
Risk factors include:
- Alcohol use
- History of meningitis
- Infection of a heart valve
- Injury or trauma to the head
- Meningitis in which there is leakage of spinal fluid
- Recent ear infection
- Recent pneumonia
- Recent upper respiratory infection
- Spleen removal
Symptoms usually come on quickly, and may include:
Signs and tests:
Physical examination will show:
- Fast heart rate
- High temperature
- Mental status changes
- Stiff neck
For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap "), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.
Tests that may be done include:
Antibiotic therapy should be started as soon as possible. Ceftriaxone is one of the most commonly used antibiotics.
If the antibiotic is not working, and the health care provider suspects antibiotic resistance, vancomycin or rifampin are used. Sometimes systemic corticosteroids may be used, especially in children.
Early treatment improves the outcome. However, 20% of people who get this disease will die of it and 50% will have serious long-term complications.
About half of all patients have long-term complications, such as the following:
Calling your health care provider:
Call the local emergency number (such as 911) or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
- Feeding difficulties
- High-pitched cry
- Persistent unexplained fever
Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.
Early treatment of pneumonia and ear infections caused by pneumococcus may decrease the risk of meningitis. There are also two effective vaccines available to prevent pneumococcus infection.
The following people should be vaccinated, according to current recommendations:
- Everyone over age 55
- People at high risk for pneumonia
Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 437.
|Review Date: 9/28/2008|
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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