Meningitis Caused by Streptococci Other Than Streptococcus Pneumoniae: A Retrospective Clinical Study

Scand J Infect Dis. 1999;31(4):375-81. doi: 10.1080/00365549950163824.

Abstract

We reviewed the medical records of 26 patients (median age 62 years, range 5-76 years) admitted to our institution during 1978-98 with acute bacterial meningitis (ABM) caused by streptococci other than Streptococcus pneumoniae (comprising 1.9% of all patients with ABM). 19 cases were community-acquired and 7 were nosocomial. 73% had comorbid or predisposing conditions and 73% had an identifiable extracerebral focus; only in 2 patients no comorbid disease, primary focus or predisposing condition was present. Five patients had cerebral abscesses, and 5 had endocarditis. Beta-haemolytic streptococci were grown in 14 cases (serotype A: 4, B: 5, C: 1, G: 4) and were predominant among patients with endocarditis, whereas alpha- or non-haemolytic strains grew in 12 cases (S. mitis: 4, S. constellatus: 2, E. faecalis: 2, S. bovis: 1, unspecified: 3) and were predominant in patients with a brain abscess. Staphylococcus aureus grew together with a streptococcus in 2 cases. Blood culture was positive in 9 cases (35%). Neurologic complications occurred in 11 patients (42%) and extraneurologic complications in 18 patients (69%). Adverse outcomes occurred in 10 patients (38%), including 3 patients who died. Occurrence of seizures at any time of disease was significantly associated with an adverse outcome; no other clinical or paraclinical features appeared to affect outcome.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Anti-Bacterial Agents
  • Child
  • Child, Preschool
  • Denmark / epidemiology
  • Drug Therapy, Combination / therapeutic use
  • Female
  • Humans
  • Incidence
  • Male
  • Meningitis, Pneumococcal / drug therapy
  • Meningitis, Pneumococcal / epidemiology*
  • Meningitis, Pneumococcal / microbiology*
  • Middle Aged
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Statistics, Nonparametric
  • Streptococcus / classification*
  • Streptococcus pneumoniae / isolation & purification
  • Survival Rate

Substances

  • Anti-Bacterial Agents