Group A streptococcal meningitis in the antibiotic era.
A case of group A streptococcal meningitis is reported and the 51 cases reported in the literature since 1966 reviewed. A total of 24 men and 24 women were included in the study; the mean age (+/-SD) was 20.9+/-25.5 years. Fifty-eight percent of the patients had comorbid conditions, 80% had a distant focus of infection, and 65.8% had blood cultures positive for group A streptococci. Seventy-five per cent of the patients were treated with penicillin. The overall case-fatality rate was 12% (6 patients). Sequelae were more prevalent among children (44%) than among adults (7.7%) (OR=9.43; 95% CI, 1.02-438.95; P=0.03). Group A streptococcus is a rare cause of pyogenic meningitis, affecting mainly children or adults with comorbidity. Although the case-fatality rate is relatively low, neurological sequelae are frequent among survivors, especially children.
Baraldés
M A
MA
Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Domingo
P
P
Mauri
A
A
Monmany
J
J
Castellanos
M
M
Pericas
R
R
Vázquez
G
G
D000328:Adult; D000368:Aged; D002439:Cefotaxime / Q000008:administration & dosage; D002511:Cephalosporins / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification*; D016896:Treatment Outcome
D002511:Cephalosporins; D002439:Cefotaxime