Group a streptococcal meningitis in adults: report of 41 cases and a review of the literature.
Chart review of 41 adult patients with group A streptococcal (GAS) meningitis in The Netherlands revealed that this is a community-acquired disease and occurs mainly in patients with predisposing factors: of the 41 patients in this case series, 24 (60%) of 40 evaluable patients had otitis or sinusitis. Fever and neck stiffness were the most common clinical manifestations of disease, but, in addition, high rates of seizures (12 [32%] of 38 patients), focal neurological findings (13 [36%] of 36 patients), and hyponatremia (20 [58%] of 35 patients) were found. In contrast with data from the literature that describes 27 adult cases, we found that GAS meningitis is a fulminant disease with a mortality rate of 27% (10 of 37 patients), and that neurological sequelae occur in 36% (12 of 38) of surviving patients.
van de Beek
Diederik
D
Department of Neurology, Academic Medical Center, and The Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam, The Netherlands. D.vandeBeek@amc.uva.nl
de Gans
Jan
J
Spanjaard
Lodewijk
L
Sela
Shlomo
S
Vermeulen
Marinus
M
Dankert
Jacob
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes / Q000187:drug effects
D000900:Anti-Bacterial Agents