Clinical features of pneumococcal meningitis

Abstract

Pneumococcal infection remains an urgent medical and social problem, causing the development of invasive forms: pneumonia, meningitis, sepsis, etc.). Objective: To evaluate the clinical features of pneumococcal meningitis (PM) and pneumococcal meningoencephalitis (PME) based on Zaporizhzhya Regional Hospital for Infectious Diseases (ZRHID). It was conducted clinical - laboratory monitoring in 26 patients with PM and PME. The evaluated group was dominated by middle aged persons - 9 (34,6%) and older - 11 (42,3%). Most of the patients (21-80,8%) the disease has developed against the background of severe co morbidity. Severe course of the disease have been reported in 24 (92,3%) patients, moderate in 2 (7.7%). Mortality rate was 15,4%. In all the dead patients, the disease began gradually and had an extremely severe course. Intensity of meningeal and intoxication syndromes determined the severity of the disease and characterized by development of hyperthermia (88,5 %) , loss of consciousness (61,5%), development of seizures (26,9%), brain edema (69%) , focal lesions of the substance the brain ( 34,6%), respiratory and hemodynamic distress (23%). Septic course was recorded in 13 patients (50%), in 3 patients (23%) it was characterized by PME with pneumococcemia phenomena presented as purpura. In 6 (46%) patients developed pneumonia, in 2 (15.4%) – phenomenon endocarditis, in 2 (15,4%) – arthritis. Multiorgan failure was accompanied by the development of renal, hepatic, respiratory and heart failure. Changes in the cerebrospinal fluid showed high neutrophilic pleocytosis in 24 patients, complete blood count - leukocytosis, neutrophilia with a left shift, elevated ESR.