© 2005 BMJ Publishing Group & Royal College of Paediatrics and Child Health
PERSPECTIVE
Meningitis
Improving the outcome of pneumococcal meningitis
1 Chief, Section of Pediatric Infectious Diseases, Boston Medical Center, Professor of Pediatrics and Epidemiology, Boston University Schools of Medicine and Public Health, USA
2 Director, Section of Pediatrics and Maternal HIV Infection, Professor of Pediatrics, Children’s Memorial Hospital, Northwestern University Medical School, USA
Correspondence to:
Correspondence to:
Dr S I Pelton
Chief, Section of Pediatric Infectious Diseases, Boston Medical Center, Professor of Pediatrics and Epidemiology, Boston University Schools of Medicine and Public Health, Boston, Massachusetts, USA; spelton@bu.edu
Commentary on the paper by McIntyre et al (see page 391)
Keywords: pneumococcal; meningitis
| The first 150 words of the full text of this article appear below. |
Bacterial meningitis continues as a major cause of morbidity and mortality among children throughout the world. McIntyre et al report on a six year experience in Australia with 122 cases of pneumococcal meningitis; 89% of cases occurred in children less than 5 years of age.1 Fifteen (13%) children died and 23 (22%) suffered severe neurological outcomes including paresis, hydrocephalus with shunting, visual loss, and marked intellectual impairment. Only 55% recovered without any identified sequelae. How can we improve the outcome of pneumococcal meningitis?
Early antibiotic treatment appears appealing as a fundamental for improving outcome, yet not all cases treated early have a good outcome. The report of McIntyre et al shows once again that children presenting "in extremis" (shock, respiratory failure, etc) are frequently beyond the full benefits of intervention regardless of whether their course was one with rapid onset or more slowly progressive after a prodromal illness. However,
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Arch. Dis. Child. 2005 90: 391-396.[Abstract] [Full Text] [PDF]
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