Pneumococcal Meningitis: An Overview

What Is Pneumococcal Meningitis?

Meningitis is an infection of the membranes that cover the brain and the spinal cord. This covering is called the meninges. After the infection, the meninges swell. Viruses cause most cases of meningitis, but bacteria are another type of germ responsible for meningitis. Streptococcus pneumoniae, a type of bacteria, causes pneumococcal meningitis.

Pneumococcal meningitis is a rare but severe illness that can become a life-threatening medical emergency. The infection might result in long-term complications and can even be fatal. It is necessary to have prompt treatment to minimize the risk of adverse outcomes.

Streptococcus pneumoniae (S. pneumoniae) is a bacteria that is widespread and responsible for many infections, including pneumonia, meningitis, and sinus infections. The bacteria spread easily and contaminate quickly from person to person through sneezing and coughing.

S. pneumoniae accounts for the most common cause of bacterial meningitis in adults. It is also one of the leading causes of bacterial meningitis in children under two years old.

Due to the introduction of the pneumococcal vaccine, the incidence of severe pneumococcal infection, including meningitis, has seen a significant reduction.

What Causes Pneumococcal Meningitis?

Pneumococcal meningitis occurs when the bacteria S. pneumoniae enters the bloodstream and infects the fluid surrounding the brain or spine. When this bacteria enters a person’s body, it does not always cause meningitis. However, it can cause many other illnesses, including:

• Ear infections.

• Blood infections.

• Sinus infections.

• Pneumonia.

In the majority of these people, the bacteria are not active or are not growing and will not cause illness. However, anyone who becomes a carrier of this bacteria can spread it to others, potentially leading to any of the diseases mentioned above or can cause pneumococcal meningitis.

The bacteria spreads through tiny droplets released from the nose or mouth of an infected person. These droplets may contaminate another person via:

• Coughing.

• Sneezing.

• Sharing food or silverware.

• Using someone else’s lipstick.

What Are the Risk Factors for Pneumococcal Meningitis?

Certain risk factors make a person more susceptible to developing pneumococcal meningitis. These include-

• Diabetes.

• Consumption of alcohol.

• Trauma or injury to the head.

• Infection of a heart valve due to S. pneumoniae.

• History of meningitis.

• Meningitis in which there is leakage of spinal fluid.

• Recent ear infection due to S. pneumoniae.

• Recent case of pneumonia due to S. pneumoniae.

• Recent upper respiratory infection.

• Removal of the spleen or a spleen that does not function.

• Cigarette smoking.

• Chronic lung, heart, liver, or kidney disease.

• Having a cochlear (inner ear) implant.

According to the centers for disease control and prevention (CDC), children who already have certain conditions that affect the spleen, such as HIV or AIDS, or sickle cell anemia, have a greater risk for pneumococcal meningitis.

What Are the Symptoms of Pneumococcal Meningitis?

The symptoms of pneumococcal meningitis start suddenly, usually after three days of the bacterial infection.

The symptoms include-

• High fever with chills.

• Stiff neck.

• Nausea and vomiting.

• Mental status changes.

• Agitation (anxiety and nervousness).

• Severe headache.

• Sensitivity to light (photophobia).

• Decreased consciousness or semi-consciousness.

• Rapid breathing.

• Arching of the head and neck backward, causing an unusual posture (opisthotonus).

In infants, pneumococcal meningitis causes poor feeding or irritability and bulging fontanelles, which means that the soft spot on the top of the head of the baby pushes outwards. Pneumococcal meningitis is also a significant cause of fever in infants.

How Is Pneumococcal Meningitis Diagnosed?

A healthcare provider will diagnose by performing a physical exam. The questions focus on symptoms and any possibility of exposure to someone who might be having the same symptoms, such as a stiff neck and fever.

If the healthcare provider suspects the possibility of pneumococcal meningitis, a lumbar puncture (spinal tap) will likely be ordered to confirm their diagnosis. A spinal tap involves the withdrawal of spinal fluid to obtain a sample from the spinal column.

Other tests may include:

• Blood Culture.

• Chest X-ray.

• CT (computed tomography) scan of the head.

• Gram stain, other special stains.

Early diagnosis is essential, as prompt treatment offers the best possible outcome.

How Is Pneumococcal Meningitis Treated?

Patients with pneumococcal meningitis will be admitted to the hospital for immediate intravenous treatment with antibiotics.

Ceftriaxone is one of the most commonly used antibiotics to treat pneumococcal meningitis. If the antibiotic is not working and the healthcare provider suspects antibiotic resistance, other antibiotics that can be used include:

• Penicillin.

• Benzylpenicillin.

• Cefotaxime.

• Chloramphenicol.

• Vancomycin.

In some situations, such as for children, doctors may prescribe corticosteroids to help reduce swelling around the brain and spinal column.

What Are the Possible Complications?

Pneumococcal meningitis may lead to long-term complications, which may include:

• Brain damage.

• A buildup of fluid between the skull and brain (subdural effusion).

• Fluid buildup inside the skull leads to brain swelling (hydrocephalus).

• Hearing loss and vision loss.

• Behavioral changes.

• Memory loss.

• Developmental delays.

How Can Pneumococcal Meningitis Be Prevented?

If pneumonia and ear infections that are caused by pneumococcus are treated early, it may reduce the risk of meningitis. Two effective vaccines are also available to prevent pneumococcus infection.

The vaccine must be administered to the following people, according to the current recommendations:

• Children.

• Adults aged 65 and older.

• People at high risk for pneumococcal infection.

When to Contact a Medical Professional?

You must contact a healthcare professional if you suspect the symptoms of meningitis in a young child, which may include-

• Feeding difficulties.

• High-pitched cry.

• Irritability.

• Persistent unexplained fever.

Meningitis can quickly escalate to become a life-threatening condition.

Conclusion:

Meningitis is a dangerous infection, and it can be fatal. Young children and adults over the age of 50 are at the greatest risk for pneumococcal meningitis. Immediate treatment is necessary for a better chance of recovery. The sooner a person visits their doctor after the appearance of the first symptoms, the better their outcome will be.