Pneumococcal meningitis is a rare but very serious illness that can develop into a life-threatening medical emergency. The infection may have long-term consequences and can even be fatal. Prompt treatment is necessary to minimize the risk of adverse outcomes.
Streptococcus pneumoniae (S. pneumoniae) is a widespread bacteria responsible for many illnesses, including meningitis, pneumonia, and sinus infections. The bacteria spread easily and quickly from person to person through coughing and sneezing.
S. pneumoniae is the most common cause of bacterial meningitis in adults. It is also among the leading causes of bacterial meningitis in children under 2 years old.
The incidence of severe pneumococcal infection, including meningitis, has decreased significantly since the introduction of the pneumococcal vaccine.
In this article, we take a look at the causes, symptoms, and treatment options for this condition.
The streptococcus pneumoniae bacteria may be passed via coughing and sneezing.
Pneumococcal meningitis occurs when S. pneumoniae enter a person's bloodstream and infect the fluid surrounding the brain or spine.
When a person has this bacteria in their system, they do not always contract meningitis. However, it causes many other illnesses, including:
- ear infections
- blood infections
- sinus infections
According to the Meningitis Research Foundation of Canada, up to 40 percent of people may carry S. pneumoniae.
In the majority of these people, the bacteria is not growing or active and will not cause illness. However, anyone who carries this bacteria can transmit it to others, potentially causing any of the illnesses above or pneumococcal meningitis.
The bacteria spread via tiny droplets released from a person's nose or mouth. These droplets may come into contact with another person via:
- sharing silverware or food
- using someone else's lipstick
Certain factors can make a person more susceptible to developing pneumococcal meningitis, including:
- decreased immune response from infection or drug use
- trauma or injury to the head
- recent ear infection with S. pneumoniae
- history of meningitis
- alcohol consumption
- cigarette smoking
- removed or non-functioning spleen
- chronic liver, lung, renal, or heart disease
- infection of a heart valve with S. pneumoniae
- having a cochlear implant
- recent case of pneumonia with S. pneumoniae
- recent upper respiratory infection
According to the Centers for Disease Control and Prevention (CDC), children with conditions affecting the spleen, such as sickle cell, HIV, or AIDS, have a much higher risk of developing pneumococcal meningitis.
The CDC also report that children of African-American descent, Alaskan natives, and some American Indian groups are at higher risk of developing the disease.
People who live in close contact with many others may be more likely to contract pneumococcal meningitis. Residing in dorms or other communal living situations may increase a person's risk of developing the condition. Children in day care may also be at higher risk.
Symptoms of pneumococcal meningitis may include stiff neck, sensitivity to light, chills, and high fever.
Pneumococcal meningitis symptoms start suddenly, usually within 3 days of infection with the bacteria. Symptoms of pneumococcal meningitis include:
- high fever
- stiff neck
- nausea and vomiting
- mental changes
- an intense headache
- sensitivity to light
- loss of consciousness or semi-consciousness
- rapid breathing
- arching of the head and neck backward
Infants with pneumococcal meningitis may have a bulging fontanelle, which means that the soft spot on top of the baby's head is pushing outward.
A doctor will begin a diagnosis by carrying out a physical exam and noting the person's symptoms.
If a doctor suspects pneumococcal meningitis, they will likely order a spinal tap to confirm the diagnosis. A spinal tap involves withdrawing a sample of spinal fluid from a person's spinal column.
A doctor may also order other tests, including:
- blood cultures
- CT scans of the head
- X-rays of the chest
Prompt diagnosis is essential, as immediate treatment offers the best possible outcome.
Intravenous antibiotic treatment may be administered in hospital to treat pneumococcal meningitis.
People with pneumococcal meningitis will be admitted to the hospital for immediate intravenous antibiotic treatment.
Typically, doctors use an antibiotic called ceftriaxone to treat pneumococcal meningitis. Other antibiotics used include:
In some situations, doctors may also prescribe corticosteroids to help reduce swelling around the brain and spinal column.
Pneumococcal meningitis is a very serious condition. As many as 1 out of 5 people die as a result of pneumococcal meningitis. Young children and adults over 65 are at the greatest risk.
A vaccination is available for those who are most prone to the condition. Those at high risk should discuss this option with their doctor. Vaccination is the only way to reduce the risk of pneumococcal meningitis in high-risk groups. All children in the U.S. are now vaccinated against S. pneumoniae.
As a result, the CDC have reported a dramatic decline in incidence rates. For example, rates of invasive pneumococcal disease have fallen from 100 cases in every 100,000 people in 1998 to 9 cases in every 100,000 people in 2015.
Pneumococcal meningitis can leave people with long-lasting problems, such as:
- hearing loss
- vision loss
- brain injury
- behavioral problems
- memory loss
- developmental delays
Prompt treatment is necessary for the best outcome — the sooner a person sees their doctor after the first symptoms appear, the better their outlook will be.