PNEUMOCOCCAL MENINGITIS IN ADULTS

A retrospective study was conducted to examine the clinical features a nd outcome of 31 adult pneumococcal meningitis patients during the yea rs 1981-92, The incidence was 1.0/100,000 adults/year. The case fatali ty rate was 16% (5/31), and in patients older than 70 years, 33% (3/9) , Sequelae were seen in 29% (7/24), mostly otoneurologic symptoms. In 27/28 bacterial isolates the serotypes found were included in the 23-v alent unconjugated polysaccharide vaccine in current use, All 28 isola tes were fully sensitive to penicillin. 49/51 non-meningitis blood iso lates had MIC values less than or equal to 0.06 mg/l, 2 isolates had M IC values of 0.125 mg/l and 0.25 mg/l, and 50/50 were serotypes includ ed in the 23-valent vaccine. Pneumococcal meningitis is a disease caus ing considerable mortality and morbidity. The relatively low case fata lity rate found in the present study may be due to the patients' good health prior to admission, rapid specific microbiological diagnosis, a bsence of penicillin-resistant pneumococci among the meningitis strain s, and immediate institution of specific and supportive therapy.