Patients with meningitis have an infection of the meninges, a tissue that covers the brain and spinal cord. Meningitis can result from a virus or bacterium. One type of meningitis, pneumococcal meningitis, is a bacterial meningitis caused by Streptococcus pneumoniae. MedlinePlus points out that Streptococcus pneumoniae commonly causes meningitis in adults.
Method of Infection
When a person becomes infected with Streptococcus pneumoniae, the bacterium needs to travel up to the brain to cause pneumococcal meningitis. The University of Chicago Pritzker School of Medicine explains that the bacterium attaches to healthy cells and multiplies. The bacterium then travels up the bloodstream to reach the cerebrospinal fluid, which surrounds the brain and spinal cord. Streptococcus pneumoniae replicates in the cerebrospinal fluid, which then infects the meninges, causing the inflammation.
Risk Factors
People with certain risk factors have a higher probability of contracting pneumococcal meningitis. For example, MedlinePlus notes that people who have had either pneumonia, an upper respiratory infection or ear infection recently have an increased risk of contracting pneumococcal meningitis. The risk is higher in people who have had meningitis in the past or had meningitis with leaking cerebrospinal fluid. A head injury or trauma, alcohol use and diabetes also increase the risk. Other risk factors for pneumococcal meningitis include a heart valve infection and a spleen removal.
Presentation of Symptoms
After the infection, patients usually have a rapid onset of symptoms, according to MedlinePlus. Patients may complain of a stiff neck or severe headache. Patients may have a high fever, which is a temperature of 103 F or higher. Photophobia can occur, in which patients have a sensitivity to light. Other symptoms of pneumococcal meningitis include increased sleepiness, confusion, nausea and vomiting.
Diagnosis Procedure
As part of the diagnosis procedure for pneumococcal meningitis, doctors need to collect a sample of cerebrospinal fluid through a lumbar puncture for testing. The sample of cerebrospinal fluid can show the changes made by Streptococcus pneumoniae. Doctors may perform other tests on the cerebrospinal fluid, such as gram stain or cerebrospinal fluid culture. MedlinePlus notes that the physical examination can reveal signs of pneumococcal meningitis, such as a stiff neck, a fast heart rate, mental status changes and a high temperature. Doctors may opt for other tests, which include a blood culture or a computerized axial tomography, or CT, scan.
Treatment
Doctors prescribe antibiotics like ceftriaxone to treat pneumococcal meningitis. Some patients may have a resistance to the antibiotics. In those cases, MedlinePlus explains that doctors can prescribe rifampin or vancomycin. While some doctors may give patients dexamethasone, a steroid, before an antibiotic, the University of Chicago Pritzker School of Medicine notes that this is controversial, as studies are mixed on whether it is beneficial or interferes with other medications, such as vancomycin.
Follow-Up
During the follow-up, doctors should look for certain signs that could indicate further problems. For example, doctors should look for signs of increased intracranial pressure, which affects nearby brain tissue. The University of Chicago Pritzker School of Medicine lists increased head circumference and high blood pressure as signs. Doctors should check patients' level of consciousness and whether they are getting enough fluids. A fever that lasts longer than seven days is a warning sign that doctors should look out for.
