Objective In the spectrum of purulent meningitis, pneumococcical meningitis (PM), caused by gram positive diplococcus pneumoniae exhibits the hardest clinical presentation to detect. The main pathological substrate is a purulent exude in the subarachnoidal space.
Aim The aim was to show characteristics of PM meningitis in hospitalized children.
Material In a retrospective study (depends on medical documents), we analyzed 7 cases of PM among 30 purulent meningitis in children, hospitalized in the Infectious Disease Clinic from 1991–1999.
Results In the first group aged from 3 to 6 years, we had 2 children, in second group aged from 7 to 18 years, there were 5 children with PM. The male/female ratio was 6:1. All had data about head injury. Interval from injury and symptom appearance was from 5 days to 6 years. In clinical findings all had fever, headache, nausea and positive meningeal signs. Lab analyses shown high ESR, WBC count, increase in fibrinogen and CRP. In the liquor we had a lot of polymorphonuclear cells, albuminorrachia ( 0.58 to 3.5 g/l) and hypogliycorrachia. In the liquor culture, we isolated streptococcus pneumoniae in all cases. All were cured by two antibiotics: Crystacillin and Chloramphenicol with corticosteroides. The duration of therapy lasted two to three weeks. In one case we had resistance to these antibiotics, except to Pentrexyl.
Conclusion All patients recovered without sequelae. Because PM is a very difficult disease to detect, the time to detection and administration of antibiotic therapy is very important to prevent mortality.