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Pneumococcal meningitis is an infection that causes swelling and irritation (inflammation) of the membranes covering the brain and spinal cord (meninges).
Pneumococcal meningitis is caused by the bacterium Streptococcus pneumoniae (also called pneumococcus). The bacteria is the most common cause of bacterial meningitis in adults, and the second most common cause of meningitis in children older than age 2.
Risk factors include:
Symptoms usually come on quickly, and may include:
Other symptoms that can occur with this disease:
Pneumococcal meningitis is an important cause of fever in children and newborns.
Physical examination will usually show:
For any patient who is suspected of having 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:
Treatment with antibiotics 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 25 - 50% will have serious long-term brain and nervous system (neurologic) complications.
About half of all patients have long-term complications, such as the following:
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:
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:
Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 437.
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