pneumococcal meningitis


Summary: An acute purulent infection of the meninges and subarachnoid space caused by Streptococcus pneumoniae, most prevalent in children and adults over the age of 60. This illness may be associated with OTITIS MEDIA; MASTOIDITIS; SINUSITIS; RESPIRATORY TRACT INFECTIONS; sickle cell disease (ANEMIA, SICKLE CELL); skull fractures; and other disorders. Clinical manifestations include FEVER; HEADACHE; neck stiffness; and somnolence followed by SEIZURES; focal neurologic deficits (notably DEAFNESS); and COMA. (From Miller et al., Merritt's Textbook of Neurology, 9th ed, p111)

Top Publications

  1. Weisfelt M, van de Beek D, Spanjaard L, Reitsma J, de Gans J. Clinical features, complications, and outcome in adults with pneumococcal meningitis: a prospective case series. Lancet Neurol. 2006;5:123-9 pubmed
    ..its clinical presentation, spectrum of complications, prognostic factors, and outcome in adults with pneumococcal meningitis. From October, 1998, to April, 2002, we assessed 352 episodes of community-acquired pneumococcal ..
  2. Østergaard C, O Reilly T, Brandt C, Frimodt Møller N, Lundgren J. Influence of the blood bacterial load on the meningeal inflammatory response in Streptococcus pneumoniae meningitis. BMC Infect Dis. 2006;6:78 pubmed
    ..We also studied CSF and blood WBC levels in 153 pneumococcal meningitis patients with and without presence of bacteraemia...
  3. Bartalesi F, Borchi B, Grilli E, Corti G, Bartoloni A. Late-onset rhabdomyolysis in pneumococcal meningitis: a case report. Intern Emerg Med. 2007;2:233-5 pubmed
  4. Bifrare Y, Kummer J, Joss P, TAUBER M, Leib S. Brain-derived neurotrophic factor protects against multiple forms of brain injury in bacterial meningitis. J Infect Dis. 2005;191:40-5 pubmed
    ..25]; P<.02). The last form of injury was associated with nuclear translocation of AIF. BDNF efficiently reduces multiple forms of neuronal injury in bacterial meningitis and may hold promise as adjunctive therapy for this disease. ..
  5. Bellac C, Coimbra R, Christen S, Leib S. Pneumococcal meningitis causes accumulation of neurotoxic kynurenine metabolites in brain regions prone to injury. Neurobiol Dis. 2006;24:395-402 pubmed
    b>Pneumococcal meningitis (PM) is characterized by an intense inflammatory host reaction that contributes to the development of cortical necrosis and hippocampal apoptosis...
  6. Njanpop Lafourcade B, Sanou O, van der Linden M, Levina N, Karanfil M, Yaro S, et al. Serotyping pneumococcal meningitis cases in the African meningitis belt by use of multiplex PCR with cerebrospinal fluid. J Clin Microbiol. 2010;48:612-4 pubmed publisher
    We reformulated a multiplex PCR algorithm for serotyping of pneumococcal meningitis directly on cerebrospinal fluid (CSF). Compared to established methods on isolates, CSF-based PCR had at least 80% sensitivity and 100% specificity...
  7. Paul R, Angele B, Popp B, Klein M, Riedel E, Pfister H, et al. Differential regulation of blood-brain barrier permeability in brain trauma and pneumococcal meningitis-role of Src kinases. Exp Neurol. 2007;203:158-67 pubmed
    ..cerebrospinal fluid (CSF) pleocytosis, brain edema formation, and bacterial outgrowth during experimental pneumococcal meningitis despite the increased cerebral expression of inflammatory chemokines, such as IL-6, CCL-9, CXCL-1, CXCL-2 ..
  8. Coimbra R, Voisin V, de Saizieu A, Lindberg R, Wittwer M, Leppert D, et al. Gene expression in cortex and hippocampus during acute pneumococcal meningitis. BMC Biol. 2006;4:15 pubmed
    b>Pneumococcal meningitis is associated with high mortality (approximately 30%) and morbidity. Up to 50% of survivors are affected by neurological sequelae due to a wide spectrum of brain injury mainly affecting the cortex and hippocampus...
  9. Zwijnenburg P, van der Poll T, Florquin S, Polfliet M, van den Berg T, Dijkstra C, et al. C1 inhibitor treatment improves host defense in pneumococcal meningitis in rats and mice. J Infect Dis. 2007;196:115-23 pubmed
    In spite of antibiotic treatment, pneumococcal meningitis continues to be associated with significant morbidity and mortality. The complement system is a key component of innate immunity against invading pathogens...

More Information


  1. Saha S, Darmstadt G, Baqui A, Hossain B, Islam M, Foster D, et al. Identification of serotype in culture negative pneumococcal meningitis using sequential multiplex PCR: implication for surveillance and vaccine design. PLoS ONE. 2008;3:e3576 pubmed publisher
    ..This PCR approach, could improve ascertainment of pneumococcal serotype distributions, especially for meningitis in settings with high prior use of antibiotics. ..
  2. Force E, Taberner F, Cabellos C, Ribes S, Domenech A, Tubau F, et al. Experimental study of meropenem in the therapy of cephalosporin-susceptible and -resistant pneumococcal meningitis. Eur J Clin Microbiol Infect Dis. 2008;27:685-90 pubmed publisher
    ..We believe that guinea pig should be considered the best choice among laboratory animal species when assessing meropenem efficacy. ..
  3. Brandt C, Holm D, Liptrot M, Ostergaard C, Lundgren J, Frimodt Møller N, et al. Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis. J Infect Dis. 2008;197:235-44 pubmed publisher
    Bacteremia plays a major role in the outcome of pneumococcal meningitis. This experimental study investigated how bacteremia influences the pathophysiologic profile of the brain...
  4. Bellac C, Coimbra R, Christen S, Leib S. Inhibition of the kynurenine-NAD+ pathway leads to energy failure and exacerbates apoptosis in pneumococcal meningitis. J Neuropathol Exp Neurol. 2010;69:1096-104 pubmed publisher
    b>Pneumococcal meningitis causes neurological sequelae, including learning and memory deficits in up to half of the survivors...
  5. Grandgirard D, Bifrare Y, Pleasure S, Kummer J, Leib S, Tauber M. Pneumococcal meningitis induces apoptosis in recently postmitotic immature neurons in the dentate gyrus of neonatal rats. Dev Neurosci. 2007;29:134-42 pubmed
    ..Previous studies have documented that in neonatal rats with experimental pneumococcal meningitis, cells in the subgranular layer of the dentate gyrus undergo apoptosis...
  6. Brandt C, Simonsen H, Liptrot M, Søgaard L, Lundgren J, Ostergaard C, et al. In vivo study of experimental pneumococcal meningitis using magnetic resonance imaging. BMC Med Imaging. 2008;8:1 pubmed publisher
    ..MRI will be a valuable technique for future studies aiming at evaluating or optimizing adjunctive treatments. ..
  7. Kadurugamuwa J, Modi K, Coquoz O, Rice B, Smith S, Contag P, et al. Reduction of astrogliosis by early treatment of pneumococcal meningitis measured by simultaneous imaging, in vivo, of the pathogen and host response. Infect Immun. 2005;73:7836-43 pubmed
    We developed a method for simultaneous in vivo biophotonic monitoring of pneumococcal meningitis and the accompanying neuronal injury in live transgenic mice...
  8. Weisfelt M, van de Beek D, Spanjaard L, Reitsma J, de Gans J. Attenuated cerebrospinal fluid leukocyte count and sepsis in adults with pneumococcal meningitis: a prospective cohort study. BMC Infect Dis. 2006;6:149 pubmed patients with meningococcal infections, the relation between CSF WBC and outcome in patients with pneumococcal meningitis is not understood...
  9. Saha S, Darmstadt G, Yamanaka N, Billal D, Nasreen T, Islam M, et al. Rapid diagnosis of pneumococcal meningitis: implications for treatment and measuring disease burden. Pediatr Infect Dis J. 2005;24:1093-8 pubmed
    ..All 122 cases of pyogenic pneumococcal meningitis positive either by culture (N = 87) or PCR (N = 35) were positive by ICT, yielding 100% (122 of 122) ..
  10. Hsu H, Shutt K, Moore M, Beall B, Bennett N, Craig A, et al. Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. N Engl J Med. 2009;360:244-56 pubmed publisher
    ..of the pediatric heptavalent pneumococcal conjugate vaccine (PCV7) in 2000, but its effect on pneumococcal meningitis is unclear...
  11. Goonetilleke U, Scarborough M, Ward S, Gordon S. Proteomic analysis of cerebrospinal fluid in pneumococcal meningitis reveals potential biomarkers associated with survival. J Infect Dis. 2010;202:542-50 pubmed publisher
    Patients with pneumococcal meningitis often die or have severe neurological damage despite optimal antibiotic therapy. New or improved therapy is required...
  12. van de Beek D, de Gans J. Dexamethasone and pneumococcal meningitis. Ann Intern Med. 2004;141:327 pubmed
  13. Kim H, Addison J, Suh E, Trune D, Richter C. Otoprotective effects of dexamethasone in the management of pneumococcal meningitis: an animal study. Laryngoscope. 2007;117:1209-15 pubmed
    To determine whether treating pneumococcal meningitis with a combined antibiotic and steroid regime will prevent cochlear damage, a common pneumococcal meningitis side effect.
  14. Kisakye A, Makumbi I, Nansera D, Lewis R, Braka F, Wobudeya E, et al. Surveillance for Streptococcus pneumoniae meningitis in children aged <5 years: implications for immunization in Uganda. Clin Infect Dis. 2009;48 Suppl 2:S153-61 pubmed publisher
    ..Minimum pneumococcal meningitis incidence estimates were calculated for a portion of the Kampala district and all of the Gulu district, ..
  15. Perin A, Nascimben E, Longatti P. Decompressive craniectomy in a case of intractable intracranial hypertension due to pneumococcal meningitis. Acta Neurochir (Wien). 2008;150:837-42; discussion 842 pubmed publisher
    ..Conclusive data on the impact of DC on the final outcome of such patients are not available yet...
  16. Echchannaoui H, Leib S, Neumann U, Landmann R. Adjuvant TACE inhibitor treatment improves the outcome of TLR2-/- mice with experimental pneumococcal meningitis. BMC Infect Dis. 2007;7:25 pubmed
    ..Toll-like receptor 2 (TLR2) contributes to host response in pneumococcal meningitis by enhancing bacterial clearing and downmodulating inflammation...
  17. Tauber S, Bunkowski S, Ebert S, Schulz D, Kellert B, Nau R, et al. Enriched environment fails to increase meningitis-induced neurogenesis and spatial memory in a mouse model of pneumococcal meningitis. J Neurosci Res. 2009;87:1877-83 pubmed publisher
    ..was observed after exposure to enriched environment (EE) and during reconvalescence from experimental pneumococcal meningitis. This study investigated neurogenesis and spatial learning performance 5 weeks after bacterial meningitis ..
  18. Schmidt H, Gerber J, Stuertz K, Djukic M, Bunkowski S, Fischer F, et al. S100B in the cerebrospinal fluid--a marker for glial damage in the rabbit model of pneumococcal meningitis. Neurosci Lett. 2010;475:104-7 pubmed publisher
    ..The rabbit model provides an important experimental setting for the evaluation of antibiotic agents against pneumococcal meningitis. One of the primary targets of this model is the study of neuronal and glial cell damage in bacterial ..
  19. Weisfelt M, Hoogman M, van de Beek D, de Gans J, Dreschler W, Schmand B. Dexamethasone and long-term outcome in adults with bacterial meningitis. Ann Neurol. 2006;60:456-68 pubmed
    ..This follow-up study of the European Dexamethasone Study was designed to examine the potential harmful effect of adjunctive dexamethasone treatment on long-term neuropsychological outcome in adults with bacterial meningitis...
  20. Dubos F, Marechal I, Husson M, Courouble C, Aurel M, Martinot A. Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France. Arch Dis Child. 2007;92:1009-12 pubmed
    The impact of the heptavalent-pneumococcal conjugate vaccine on the incidence of pneumococcal meningitis in Europe has not yet been assessed.
  21. Bellac C, Coimbra R, Simon F, Imboden H, Leib S. Gene and protein expression of galectin-3 and galectin-9 in experimental pneumococcal meningitis. Neurobiol Dis. 2007;28:175-83 pubmed
    ..e. cortical necrosis and hippocampal apoptosis in pneumococcal meningitis (PM). Galectin-3 and -9 are known pro-inflammatory mediators and regulators of apoptosis...
  22. Ubukata K, Chiba N, Hasegawa K, Kobayashi R, Iwata S, Sunakawa K. Antibiotic susceptibility in relation to penicillin-binding protein genes and serotype distribution of Streptococcus pneumoniae strains responsible for meningitis in Japan, 1999 to 2002. Antimicrob Agents Chemother. 2004;48:1488-94 pubmed
    ..9 and 56.0%, respectively). These findings suggest the need for early introduction of pneumococcal conjugate vaccines and continuous bacteriological surveillance for meningitis...
  23. Meli D, Coimbra R, Erhart D, Loquet G, Bellac C, TAUBER M, et al. Doxycycline reduces mortality and injury to the brain and cochlea in experimental pneumococcal meningitis. Infect Immun. 2006;74:3890-6 pubmed
    ..In an infant rat model of pneumococcal meningitis, a single dose of doxycycline (30 mg/kg) given as adjuvant therapy in addition to ceftriaxone 18 h after ..
  24. Jansen A, Rodenburg G, van der Ende A, van Alphen L, Veenhoven R, Spanjaard L, et al. Invasive pneumococcal disease among adults: associations among serotypes, disease characteristics, and outcome. Clin Infect Dis. 2009;49:e23-9 pubmed publisher
    ..The Streptococcus pneumoniae polysaccharide capsule may be related to invasive pneumococcal disease (IPD) course...
  25. Angstwurm K, Hanisch U, Gassemi T, Bille M, Prinz M, Dirnagl U, et al. Tyrosine kinase inhibition reduces inflammation in the acute stage of experimental pneumococcal meningitis. Infect Immun. 2004;72:3294-8 pubmed
  26. Motlova J, Benes C, Kriz P. Incidence of invasive pneumococcal disease in the Czech Republic and serotype coverage by vaccines, 1997-2006. Epidemiol Infect. 2009;137:562-9 pubmed publisher
    ..The incidence of pneumococcal meningitis based on routine notification data varied between 0.4 and 0.6/100 000 population between 1997 and 2006...
  27. Sury M, Agarinis C, Widmer H, Leib S, Christen S. JNK is activated but does not mediate hippocampal neuronal apoptosis in experimental neonatal pneumococcal meningitis. Neurobiol Dis. 2008;32:142-50 pubmed publisher
    b>Pneumococcal meningitis is associated with caspase 3-dependent apoptosis of recently post-mitotic immature neurons in the dentate gyrus of the hippocampus...
  28. Klugman K, Walsh A, Phiri A, Molyneux E. Mortality in penicillin-resistant pneumococcal meningitis. Pediatr Infect Dis J. 2008;27:671-2 pubmed publisher
  29. Brandt C, Frimodt Møller N, Lundgren J, Pedersen M, Skovsted I, Rowland I, et al. Evaluation of anti-pneumococcal capsular antibodies as adjunctive therapy in experimental pneumococcal meningitis. J Antimicrob Chemother. 2006;58:1291-4 pubmed
    Bacteraemia concomitant with meningitis has been shown to greatly affect outcome. Consequently, the efficacy of serotype-specific anti-pneumococcal antiserum (APAS) was investigated in a rat model of pneumococcal meningitis.
  30. Brouwer M, Heckenberg S, de Gans J, Spanjaard L, Reitsma J, van de Beek D. Nationwide implementation of adjunctive dexamethasone therapy for pneumococcal meningitis. Neurology. 2010;75:1533-9 pubmed publisher
    In this nationwide prospective cohort study, we evaluated the implementation of adjunctive dexamethasone therapy in Dutch adults with pneumococcal meningitis.
  31. Pedersen M, Brandt C, Knudsen G, Ostergaard C, Skinhøj P, Frimodt Møller N, et al. Cerebral blood flow autoregulation in early experimental S. pneumoniae meningitis. J Appl Physiol (1985). 2007;102:72-8 pubmed
    ..pneumoniae in rats. Impairment of CBF autoregulation precedes the increase in ICP, and acute hypocapnia may restore autoregulation without changing the ICP...
  32. Papadopoulos M, Verkman A. Aquaporin-4 gene disruption in mice reduces brain swelling and mortality in pneumococcal meningitis. J Biol Chem. 2005;280:13906-12 pubmed
    ..Our findings provide a novel molecular mechanism for the pathogenesis of brain edema in acute bacterial meningitis, and suggest that inhibition of AQP4 function or up-regulation may dramatically improve clinical outcome...
  33. Traore Y, Tameklo T, Njanpop Lafourcade B, Lourd M, Yaro S, Niamba D, et al. Incidence, seasonality, age distribution, and mortality of pneumococcal meningitis in Burkina Faso and Togo. Clin Infect Dis. 2009;48 Suppl 2:S181-9 pubmed publisher
    ..In Burkina Faso, the annual incidence rate of pneumococcal meningitis was 14 cases per 100,000 persons, with annual incidence rates of 77, 33, 10, and 11 cases per 100,000 ..
  34. Moïsi J, Saha S, Falade A, Njanpop Lafourcade B, Oundo J, Zaidi A, et al. Enhanced diagnosis of pneumococcal meningitis with use of the Binax NOW immunochromatographic test of Streptococcus pneumoniae antigen: a multisite study. Clin Infect Dis. 2009;48 Suppl 2:S49-56 pubmed publisher
    ..The ICT results were positive for 68 (99%) of the 69 culture-confirmed pneumococcal meningitis cases and negative for 124 (99%) of 125 culture-confirmed bacterial meningitis cases caused by other ..
  35. Tsai C, Griffin M, Nuorti J, Grijalva C. Changing epidemiology of pneumococcal meningitis after the introduction of pneumococcal conjugate vaccine in the United States. Clin Infect Dis. 2008;46:1664-72 pubmed publisher
    ..due to invasive pneumococcal disease decreased after routine vaccination of young children with a 7-valent pneumococcal conjugate vaccine (PCV7) began in 2000, information on the trends in pneumococcal meningitis is limited.
  36. Mook Kanamori B, Rouse M, Kang C, van de Beek D, Steckelberg J, Patel R. Daptomycin in experimental murine pneumococcal meningitis. BMC Infect Dis. 2009;9:50 pubmed publisher
    Daptomycin, a lipopeptide antibiotic, could be an alternative to vancomycin for treatment of pneumococcal meningitis. We determined the activity of daptomycin versus vancomycin, with dexamethasone as an adjuvant, in a murine model of ..
  37. Isapof A, Delacourt C, Reinert P, Cohen R, Madhi F. [Serotype 19F pneumococcal meningitis in an imunocompetent infant immunized with heptavalent pneumococcal conjugated vaccine Prevenar]. Arch Pediatr. 2009;16:1133-6 pubmed publisher
    Seven cases of pneumococcal meningitis caused by serotypes covered by the available vaccine occurred in France in vaccinated children, 4 of which were caused by serotype 19F.
  38. Echchannaoui H, Frei K, Letiembre M, Strieter R, Adachi Y, Landmann R. CD14 deficiency leads to increased MIP-2 production, CXCR2 expression, neutrophil transmigration, and early death in pneumococcal infection. J Leukoc Biol. 2005;78:705-15 pubmed
    ..In conclusion, CD14 plays a protective role in pneumococcal meningitis by slowing PMN migration via MIP-2 and CXCR2 modulation.
  39. Wellmer A, von Mering M, Spreer A, Diem R, Eiffert H, Noeske C, et al. Experimental pneumococcal meningitis: impaired clearance of bacteria from the blood due to increased apoptosis in the spleen in Bcl-2-deficient mice. Infect Immun. 2004;72:3113-9 pubmed
    Necrotic and apoptotic neuronal cell death can be found in pneumococcal meningitis. We investigated the role of Bcl-2 as an antiapoptotic gene product in pneumococcal meningitis using Bcl-2 knockout (Bcl-2(-/-)) mice...
  40. Echchannaoui H, Bachmann P, Letiembre M, Espinosa M, Landmann R. Regulation of Streptococcus pneumoniae distribution by Toll-like receptor 2 in vivo. Immunobiology. 2005;210:229-36 pubmed
    ..The results indicate that TLR2 does not change bacterial distribution, but may contribute to antibacterial defense by modulating S. pneumoniae adherence and uptake in plexus epithelia...
  41. de Andrade A, Pimenta F, Laval C, de Andrade J, Guerra M, Brandileone M. Invasive pneumococcal infection in a healthy infant caused by two different serotypes. J Clin Microbiol. 2004;42:2345-6 pubmed
  42. Gerber J, Böttcher T, Hahn M, Siemer A, Bunkowski S, Nau R. Increased mortality and spatial memory deficits in TNF-alpha-deficient mice in ceftriaxone-treated experimental pneumococcal meningitis. Neurobiol Dis. 2004;16:133-8 pubmed
    ..In a mouse model of ceftriaxone-treated pneumococcal meningitis, spatial memory and motor performance of TNF-alpha-deficient (n = 57) and control mice (n = 55) were ..
  43. Østergaard C, Konradsen H, Samuelsson S. Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection. BMC Infect Dis. 2005;5:93 pubmed
    ..We conducted a nationwide study in Denmark to identify clinical features and prognostic factors in patients with Streptococcus pneumoniae according to the focus of infection...
  44. Braun J. Inducible nitric oxide synthase mediates hippocampal caspase-3 activation in pneumococcal meningitis. Int J Neurosci. 2009;119:455-9 pubmed publisher
    ..synthase (iNOS)--is a major inflammatory mediator clearly upregulated in the cerebrospinal fluid during pneumococcal meningitis. However, its effects in bacterial meningitis are still controversial...
  45. Tauber S, Stadelmann C, Spreer A, Bruck W, Nau R, Gerber J. Increased expression of BDNF and proliferation of dentate granule cells after bacterial meningitis. J Neuropathol Exp Neurol. 2005;64:806-15 pubmed
    ..004). No significant changes in GDNF expression were observed. In conclusion, increased synthesis of BDNF and TrkB suggests a contribution of this neurotrophic factor to neurogenesis after bacterial meningitis...
  46. Weisfelt M, de Gans J, van der Poll T, van de Beek D. Pneumococcal meningitis in adults: new approaches to management and prevention. Lancet Neurol. 2006;5:332-42 pubmed
    ..eradication of meningitis due to Haemophilus influenzae type B by vaccination in the developed world, pneumococcal meningitis has become the leading cause of bacterial meningitis beyond the neonatal period...
  47. Østergaard C, Leib S, Rowland I, Brandt C. Bacteremia causes hippocampal apoptosis in experimental pneumococcal meningitis. BMC Infect Dis. 2010;10:1 pubmed publisher
    ..systemic complications both play important roles in brain pathophysiological alterations and the outcome of pneumococcal meningitis. Their individual contributions to the development of brain damage, however, still remain to be defined.
  48. Chiavolini D, Tripodi S, Parigi R, Oggioni M, Blasi E, Cintorino M, et al. Method for inducing experimental pneumococcal meningitis in outbred mice. BMC Microbiol. 2004;4:36 pubmed
    Streptococcus pneumoniae is the leading cause of bacterial meningitis. Pneumococcal meningitis is associated with the highest mortality among bacterial meningitis and it may also lead to neurological sequelae despite the use of ..
  49. Casado Flores J, Aristegui J, de Liria C, Martínón J, Fernandez C. Clinical data and factors associated with poor outcome in pneumococcal meningitis. Eur J Pediatr. 2006;165:285-9 pubmed
    We carried out a 4-year study of 159 children (ages 1 month-14 years) with pneumococcal meningitis. The study was divided into two periods: the retrospective period (1998-2000: 107 patients), and the prospective period (2001-2002: 52 ..
  50. Yaro S, Lourd M, Traore Y, Njanpop Lafourcade B, Sawadogo A, Sangare L, et al. Epidemiological and molecular characteristics of a highly lethal pneumococcal meningitis epidemic in Burkina Faso. Clin Infect Dis. 2006;43:693-700 pubmed
    ..Public health and clinical strategies for meningitis epidemics in sub-Saharan Africa usually assume that Neisseria meningitidis infection causes most disease...
  51. Brandenburg L, Varoga D, Nicolaeva N, Leib S, Wilms H, Podschun R, et al. Role of glial cells in the functional expression of LL-37/rat cathelin-related antimicrobial peptide in meningitis. J Neuropathol Exp Neurol. 2008;67:1041-54 pubmed publisher
    ..Together, these results suggest that cathelicidins produced by glia and other cells play an important part in the innate immune response against pathogens in central nervous system bacterial infections...
  52. Orihuela C, Gao G, Francis K, Yu J, Tuomanen E. Tissue-specific contributions of pneumococcal virulence factors to pathogenesis. J Infect Dis. 2004;190:1661-9 pubmed
    ..We conclude that transitions between body sites require virulence determinants distinct from those involved in organ-specific replication...
  53. Letiembre M, Echchannaoui H, Ferracin F, Rivest S, Landmann R. Toll-like receptor-2 deficiency is associated with enhanced brain TNF gene expression during pneumococcal meningitis. J Neuroimmunol. 2005;168:21-33 pubmed
    ..Toll-like receptor-2 (TLR2), we studied temporal and anatomical expression patterns of TLR2 and TNF in a pneumococcal meningitis model in wild type (wt) and TLR2(-/-) mice...
  54. Killingley B, Carpenter V, Flanagan K, Pasvol G. Pneumococcal meningitis and etanercept--chance or association?. J Infect. 2005;51:E49-51 pubmed
    ..We report the first case of a patient with rheumatoid arthritis who developed pneumococcal meningitis whilst on etanercept, suggesting a possible association between etanercept and this severe life ..
  55. Grandgirard D, Schürch C, Cottagnoud P, Leib S. Prevention of brain injury by the nonbacteriolytic antibiotic daptomycin in experimental pneumococcal meningitis. Antimicrob Agents Chemother. 2007;51:2173-8 pubmed
    ..with nonbacteriolytic daptomycin was compared with that of bacteriolytic ceftriaxone in experimental pneumococcal meningitis, and the treatments were evaluated for their effects on inflammation and brain injury...
  56. Hadem J, Cornberg M, Hauptmann C, Süttmann U, Manns M, Wedemeyer H. Pneumococcal meningitis during antiviral treatment with interferon and ribavirin in a splenectomized patient with chronic hepatitis C - do not miss vaccination before starting therapy. Z Gastroenterol. 2008;46:880-2 pubmed publisher
    We report on a 35-year-old man who developed pneumococcal meningitis while receiving antiviral therapy with interferon (consensus interferon, CIFN) and ribavirin for chronic hepatitis C...
  57. Sellner J, Leib S. In bacterial meningitis cortical brain damage is associated with changes in parenchymal MMP-9/TIMP-1 ratio and increased collagen type IV degradation. Neurobiol Dis. 2006;21:647-56 pubmed
    ..of MMP) and the structural integrity of the BBB in relation to cortical damage in an infant rat model of pneumococcal meningitis. The data demonstrate that the extent of cortical damage is significantly associated with parenchymal ..
  58. Wei B, Robins Browne R, Shepherd R, Clark G, O Leary S. Can we prevent cochlear implant recipients from developing pneumococcal meningitis?. Clin Infect Dis. 2008;46:e1-7 pubmed publisher
    ..However, pneumococcal meningitis in implant recipients has received high profile public attention as a result of the US Food and Drug ..
  59. Ispahani P, Slack R, Donald F, Weston V, Rutter N. Twenty year surveillance of invasive pneumococcal disease in Nottingham: serogroups responsible and implications for immunisation. Arch Dis Child. 2004;89:757-62 pubmed
    ..To determine the major serogroups of Streptococcus pneumoniae responsible for invasive disease and the potential coverage by the new pneumococcal conjugate vaccines...
  60. McIntyre P, Macintyre C, Gilmour R, Wang H. A population based study of the impact of corticosteroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis. Arch Dis Child. 2005;90:391-6 pubmed
    Despite an extensive literature, the impact of both adjunctive steroid therapy and delayed diagnosis on the outcome of childhood pneumococcal meningitis is controversial.
  61. Levy C, Varon E, Bingen E, Picard C, de La Rocque F, Aujard Y, et al. [Pneumococcal meningitis in children in France: 832 cases from 2001 to 2007]. Arch Pediatr. 2008;15 Suppl 3:S111-8 pubmed publisher
    b>Pneumococcal meningitis represents one major cause of morbidity and mortality in children in France...
  62. Djukic M, Mildner A, Schmidt H, Czesnik D, Bruck W, Priller J, et al. Circulating monocytes engraft in the brain, differentiate into microglia and contribute to the pathology following meningitis in mice. Brain. 2006;129:2394-403 pubmed
    ..Thus, circulating cells entering the brain such as monocytes/macrophages might provide a potential cellular target for the treatment of the tissue damage following meningitis via peripheral cell therapy...
  63. Sare G, Varma A, Green K, Herwadkar A, Gnanalingham K. Pneumococcal meningitis secondary to intra-sphenoidal encephalocoele. Acta Neurochir (Wien). 2009;151:103-4 pubmed publisher
    ..Initial endoscopic transsphenoidal repair was unsuccessful, necessitating a combined subtemporal and transsphenoidal approach to close the defect...
  64. Brandt C, Lundgren J, Lund S, Frimodt Møller N, Christensen T, Benfield T, et al. Attenuation of the bacterial load in blood by pretreatment with granulocyte-colony-stimulating factor protects rats from fatal outcome and brain damage during Streptococcus pneumoniae meningitis. Infect Immun. 2004;72:4647-53 pubmed
    A model of pneumococcal meningitis in young adult rats receiving antibiotics once the infection was established was developed. The intent was to mimic clinical and histopathological features of pneumococcal meningitis in humans...
  65. Liu X, Han Q, Sun R, Li Z. Dexamethasone regulation of matrix metalloproteinase expression in experimental pneumococcal meningitis. Brain Res. 2008;1207:237-43 pubmed publisher
    ..However, the role of dexamethasone in the pathophysiology of pneumococcal meningitis is still unknown...
  66. van der Flier M, Coenjaerts F, Mwinzi P, Rijkers E, Ruyken M, Scharringa J, et al. Antibody neutralization of vascular endothelial growth factor (VEGF) fails to attenuate vascular permeability and brain edema in experimental pneumococcal meningitis. J Neuroimmunol. 2005;160:170-7 pubmed
    ..56, P=0.004), and brain water content (r=0.42, P=0.04). Blocking of VEGF did not attenuate brain edema, blood-brain barrier disruption, or CSF pleocytosis. The functional role of VEGF in the pathophysiology of BM remains elusive...
  67. Stucki A, Cottagnoud M, Winkelmann V, Schaffner T, Cottagnoud P. Daptomycin produces an enhanced bactericidal activity compared to ceftriaxone, measured by [3H]choline release in the cerebrospinal fluid, in experimental meningitis due to a penicillin-resistant pneumococcal strain without lysing its cell wall. Antimicrob Agents Chemother. 2007;51:2249-52 pubmed
    Daptomycin monotherapy was superior to ceftriaxone monotherapy and was highly efficacious in experimental pneumococcal meningitis, sterilizing the cerebrospinal fluid (CSF) of three of three rabbits after 4 to 6 h...
  68. Saha S, Khan N, Ahmed A, Amin M, Hanif M, Mahbub M, et al. Neurodevelopmental sequelae in pneumococcal meningitis cases in Bangladesh: a comprehensive follow-up study. Clin Infect Dis. 2009;48 Suppl 2:S90-6 pubmed publisher
    Evaluation of the long-term impact of pneumococcal meningitis on surviving children and their families is critical to fully comprehending the burden of pneumococcal disease and to facilitating an evidence-based decision for the ..
  69. Brouwer M, de Gans J, Heckenberg S, Kuiper H, van Lieshout H, van de Beek D. Vertebral osteomyelitis complicating pneumococcal meningitis. Neurology. 2008;71:612-3 pubmed publisher
  70. Bingen E, Levy C, Varon E, de La Rocque F, Boucherat M, D Athis P, et al. Pneumococcal meningitis in the era of pneumococcal conjugate vaccine implementation. Eur J Clin Microbiol Infect Dis. 2008;27:191-9 pubmed
    ..Diseases Group set up an active surveillance network to analyze the clinical and biological features of pneumococcal meningitis and the impact of the seven-valent pneumococcal conjugate vaccine (PCV7)...
  71. Coimbra R, Loquet G, Leib S. Limited efficacy of adjuvant therapy with dexamethasone in preventing hearing loss due to experimental pneumococcal meningitis in the infant rat. Pediatr Res. 2007;62:291-4 pubmed
    ..However, in infant rats, pneumococcal meningitis (PM) increased auditory brainstem response (ABR) thresholds [mean difference = 54 decibels sound pressure ..
  72. Meli D, Loeffler J, Baumann P, Neumann U, Buhl T, Leppert D, et al. In pneumococcal meningitis a novel water-soluble inhibitor of matrix metalloproteinases and TNF-alpha converting enzyme attenuates seizures and injury of the cerebral cortex. J Neuroimmunol. 2004;151:6-11 pubmed
    ..inhibitor of MMP and TACE, on disease parameters and brain damage in a neonatal rat model of pneumococcal meningitis. At 1 mg/kg q6h TNF484 reduced soluble TNF-alpha and the collagen degradation product hydroxyproline in ..
  73. Wittwer M, Grandgirard D, Rohrbach J, Leib S. Tracking the transcriptional host response from the acute to the regenerative phase of experimental pneumococcal meningitis. BMC Infect Dis. 2010;10:176 pubmed publisher
    Despite the availability of effective antibiotic therapies, pneumococcal meningitis (PM) has a case fatality rate of up to 30% and causes neurological sequelae in up to half of the surviving patients...
  74. Tzanakaki G, Mastrantonio P. Aetiology of bacterial meningitis and resistance to antibiotics of causative pathogens in Europe and in the Mediterranean region. Int J Antimicrob Agents. 2007;29:621-9 pubmed
    ..This work reviews the epidemiology of bacterial meningitis in Europe and in the Mediterranean region as well as the antimicrobial susceptibility of the etiological agents...
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    This study evaluated the role of linezolid in the treatment of patients suffering from pneumococcal meningitis. Treatment included ceftriaxone (4000 mg every 24 h), linezolid (600 mg every 12 h) and dexamethasone (8 mg every 6 h)...
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