Pneumococcal meningitis

Abstract

Streptococcus pneumoniae is one of the most common causes of bacterial meningitis, with high mortality and morbidity rates. Although some of the signs and symptoms of meningitis may e absent, virtually all patients present with at least one of the classic triad symptoms of a fever, neck stiffness and altered mental status. It is imperative to start empiric antimicrobial treatment as soon as possible. Treatment is started with ceftriaxone, and needs to be switched to an appropriate alternative as soon as microbiological test results are available. Patients should be offered suitable analgesia and monitored for hydration and nutritional status. Appropriate follow-up care includes hearing tests, physiotherapy, occupational therapy, educational support, speech and language therapy, and referral to the mental health services, if necessary. The introduction of pneumococcal vaccination has reduced the incidence of invasive pneumococcal disease and resistant invasive pneumococcal disease. This article provides an overview of the causes, signs and symptoms, treatment, complications and prevention of bacterial, and specifically pneumococcal, meningitis.