title: Postpartum maternal pneumococcal meningitis complicated by endocarditis.
abstract: Bacterial meningitis is associated with high morbidity and mortality. Few cases of pneumococcal meningitis during pregnancy and the postpartum period have been reported. We describe a case of postpartum pneumococcal meningitis complicated by endocarditis. A 26-year-old para-2 woman who had had a normal vaginal delivery at 38 weeks at a maternity home was transported to our hospital with a 39.5°C fever 11 days postpartum. Eight hours after her arrival, her state of consciousness deteriorated rapidly. Lumbar puncture revealed Gram-positive cocci consistent with Streptococcus pneumoniae. She was immediately treated with antibiotics and subsequently diagnosed with endocarditis. Final culture results from the blood and cerebrospinal fluid confirmed the presence of S. pneumoniae. She recovered completely with no evidence of neurological damage. Maintaining a high clinical suspicion and initiating appropriate diagnostic testing and therapeutic interventions promptly are essential to reducing the morbidity and mortality associated with bacterial meningitis.
authors.affiliation: Department of Obstetrics and Gynecology, National Center for Global Health and Medicine, Shinjuku, Japan. jkakogaw@hosp.ncgm.go.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Kakogawa
authors.forename: Seiya
authors.initials: S
authors.lastname: Orito
authors.forename: Norio
authors.initials: N
authors.lastname: Masuya
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sadatsuki
authors.forename: Hideto
authors.initials: H
authors.lastname: Gomibuchi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Minoura
mesh_terms: D000328:Adult; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008586:Meningitis, Pneumococcal / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D011645:Puerperal Infection / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy