Journal Article

A 20-Year Epidemiological Study of Pneumococcal Meningitis

Ronald J. Stanek and Maurice A. Mufson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 6, pages 1265-1272
Published in print June 1999 | ISSN: 1058-4838
Published online June 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514777
A 20-Year Epidemiological Study of Pneumococcal Meningitis

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We conducted a retrospective analysis of 55 community-acquired Streptococcus pneumoniae meningitis illnesses in Huntington, West Virginia, from 1978 to 1997. Fourteen (36.8%) of 38 adults and 2 (11.8%) of 17 children died. Serotypes 6, 23, 3, and 18 accounted for 20 (41.7%) of 48 strains available for serotyping. Of 40 strains available for antimicrobial susceptibility testing, 1 serotype 19 and 1 serotype 23 strain showed intermediate resistance and a second serotype 23 strain showed high resistance to penicillin; all three patients survived. The case-fatality rates among adults who received penicillin alone, gentamicin in combination, or vancomycin and cephalosporin together were 57.1%, 55.5%, and 60%, respectively, and among those who received chloramphenicol or a third-generation cephalosporin, they were 11.1% or nil, respectively. No child died who received chloramphenicol or vancomycin. Two (33%) of 6 children died who received a third-generation cephalosporin; both were critically ill when initially treated. No child and one adult had received pneumococcal vaccine prior to becoming ill.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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