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CC BY-NC-ND 4.0 · Neuropediatrics 2022; 53(01): 032-038
DOI: 10.1055/s-0041-1728655
Original Article

Clinical Features and Outcomes of Streptococcus pneumoniae Meningitis in Children: A Retrospective Analysis of 26 Cases in China

Wenhui Wang
1   Department of Neurology, Children's Hospital of Shanxi, Taiyuan, Shanxi, China
,
Hong Han
1   Department of Neurology, Children's Hospital of Shanxi, Taiyuan, Shanxi, China
,
Lijun Du
1   Department of Neurology, Children's Hospital of Shanxi, Taiyuan, Shanxi, China
,
Zhaoyang Li
1   Department of Neurology, Children's Hospital of Shanxi, Taiyuan, Shanxi, China
,
Yunhong Wu
1   Department of Neurology, Children's Hospital of Shanxi, Taiyuan, Shanxi, China
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Abstract

Background Streptococcus pneumoniae is an important cause of pediatric meningitis.

Objective The aim of this study was to analyze the clinical features and outcomes of children with pneumococcal meningitis at our hospital in China, so as to provide basis for improving the clinical treatment effect.

Methods This retrospective analysis included patients aged <16 years treated for pneumococcal meningitis at the Department of Neurology, Children's Hospital of Shanxi (January 2014–February 2016). Clinical data were extracted from the medical records. Patients were followed up for 6 months after discharge.

Results The analysis included 26 children aged 2 months to 13 years, with 17 (65.4%) aged <3 years. Presenting symptoms included fever (100%), lethargy (100%), impaired consciousness (88.5%), neck stiffness (69.2%), seizures (53.8%), and headache (50.0%). All patients had positive cerebrospinal fluid (CSF) cultures. The final treatment was vancomycin combined with a third-generation cephalosporin or other antibiotics in 25 patients. Eleven patients (42.3%) were recovered, 3 (11.5%) had neurological sequelae, and 12 (46.2%) died. Impaired consciousness (p = 0.035), cerebral hernia (p = 0.037), respiratory failure (p = 0.004), heart failure (p = 0.044), septic shock (p = 0.037), low CSF white blood cell count (p = 0.036), high CSF protein levels (p = 0.028), low white blood cell count (p = 0.036), and low blood neutrophil ratio (p = 0.016) are associated with a poor prognosis to pneumococcal meningitis.

Conclusion Pneumococcal meningitis is associated with a poor prognosis in many children. Poor prognosis might be related to early ineffective antibiotic therapy, a combination of systemic failure, neurological problems, and changed inflammatory response. It is important to rapid initiation of appropriate antibiotic therapy if meningitis is suspected.

Keywords

Streptococcus pneumoniae - meningitis - children - infants - neurological complications

Supplementary Material



Publication History

Received: 13 March 2020

Accepted: 14 February 2021

Article published online:
13 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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