PNEUMOCOCCAL MENINGITIS - CLINICAL AND LABORATORY STUDY

  • 1 January 1976
    • journal article
    • research article
    • Vol. 45  (180) , 583-601
Abstract
Patients (42) who were admitted consecutively with pneumococcal meningitis during an 18 mo. period were studied in Ahmadu Bello University Hospital, Zaria, Nigeria. The disease was seen most frequently in older children and young adults. A predisposing condition was found in only 4 patients. Counter-current immunoelectrophoresis was a rapid and effective method of diagnosis. Pneumococcal polysaccharide antigen was found in the initial CSF sample from all but 1 patient. Detailed physiological studies carried out in 2 patients showed profound disturbances of cerebral carbohydrate metabolism and an increase in cerebral vascular resistance. Twenty patients died (48%) despite treatment with large doses of penicillin. A fatal outcome was associated with impairment of consciousness on admission, a low CSF white cell count and a high CSF antigen titer. Marked changes in cerebral carbohydrate metabolism, and perhaps vascular damage, may play important roles in producing severe brain damage in patients with pneumococcal meningitis. Defective CSF polymorphoneutrophil leukocyte function may contribute to the failure of the infection to respond satisfactorily to antibiotic therapy.