Table 1 Characteristics of 187 patients with S. pneumoniae meningitis according to the focus of the infection.
% or median (25/75 percentiles) and (No/total) | All cases (N = 187) | Otogenic focus (N = 57) | Sinusitic focus (N = 15) | Pneumonic focus (N = 33) | Other foci (N = 4) | No primary infection focus (N = 78) |
|---|---|---|---|---|---|---|
Sex (female/male) | 91/96 | 34/23 | 9/6 | 15/18 | 3/1 | 30/48 |
Age (in years) | 55 (22–69) | 56 (37–71) | 66 (39–73) | 58 (44–70) | 75 (55–81) | 49 (1–64) |
<16 years of age | 24% (45/187) | 21% (12/57) | 7% (1/15) | 9% (3/33) | 0% (0/4) | 37% (29/78) |
Predisposing condition* | 12 % (23/185) | 11% (6/57) | 27% (4/15) | 6% (2/33) | 0% (0/4) | 15% (11/76) |
Underlying disease§ | 18% (33/185) | 14% (8/57) | 20% (3/15) | 36% (12/33) | 25% (1/4) | 12% (9/76) |
Clinical features on admission | ||||||
Fever | 93% (155/166) | 98% (55/56) | 92% (12/13) | 100% (27/27) | 75% (3/4) | 95% (63/66) |
Headache | 41% (48/116) | 44% (17/39) | 63% (5/8) | 40% (6/15) | 0% (0/3) | 39% (20/51) |
Back rigidity | 57% (86/151) | 65% (34/52) | 75% (9/12) | 41% (9/22) | 25% (1/4) | 54% (33/61) |
Decreased consciousness | 94% (165/176) | 98% (53/54) | 86% (12/14) | 93% (28/30) | 100% (4/4) | 92% (68/74) |
Convulsion (Debut before/ after admission) | 31% (54/175) 11% (19/175) 17% (29/175) | 23% (13/56) 5% (3/56) 18% (10/56) | 33% (5/15) 20% (3/15) 13% (2/15) | 41% (12/29) 10% (3/29) 31% (9/29) | 50% (2/4) 0% (0/0) 50% (2/4) | 31% (22/71) 14% (10/71) 17% (12/71) |
Duration of symptoms | 2 days (2–4) (111/187) | 2 days (1–4) (53/57) | 3 days (2–7) (11/15) | 3 days (2–8) (12/33) | 3 days (1–5) (3/4) | 2 days (2–3) (37/76) |
Mechanical ventilation | 58% (97/168) | 49% (25/51) | 50% (6/12) | 77% (24/31) | 100% (4/4) | 54% (38/70) |
CT-scan before lumbar puncture | 11% (21/187) | 7% (4/57) | 13% (2/15) | 12% (4/33) | 0% (0/4) | 14% (11/78) |
Steroid therapy | 16% (26/163) | 14% (7/51) | 8% (2/13) | 19% (5/26) | 0% (0/4) | 17% (12/69) |
Paraclinical findings CSF WBC (cells/μL) | 1842 (291–4419) (149/187) | 2844 (914–4553)## (50/57) | 119 (41–5489) (12/15) | 497 (66–2708) (24/33) | 38 (1–235) (4/4) | 2475 (850–4650)¤¤ (59/78) |
CSF protein (g/L) | 2.7 (1.4–5.8) (123/187) | 3.1 (1.7–5.9) (44/57) | 4.0 (1.0–9.0) (10/15) | 2.8 (1.0–6.0) (18/33) | 8.2 (0.5–10) (3/4) | 2.3 (1.3–4.4) (48/78) |
CSF glucose (mmol/L) | 0.9 (0.4–2.8) (129/187) | 0.9 (0.4–2.6) (45/57) | 0.7 (0.1–3.0) (11/15) | 0.9 (0.3–3.2) (21/33) | 2.4 (0.6–3.7) (3/4) | 0.9 (0.4–2.9) (49/78) |
CSF/blood glucose ratio | 0.1 (0.04–0.4) (93/187) | 0.1 (0.05–0.3) (29/57) | 0.05 (0.01–0.4) (9/15) | 0.07 (0.01–0.4) (18/33) | 0.5 (0.09–0.9) (2/4) | 0.2 (0.04–0.5) (35/78) |
Positive CSF culture | 95% (176/186) | 93% (53/57) | 100% (15/15) | 91% (29/32) | 100% (4/4) | 96% (75/78) |
Blood WBC (109 cells/L) | 17.3 (10.5–25.7) (134/187) | 17.6 (10.5–24.1) (29/57) | 20.0 (8.9–26.2) (12/15) | 12.6 (7.9–22.9) (23/33) | 10.2 (6.7–19) (3/4) | 17.9 (14.1–27.7) (50/78) |
Positive blood culture | 67% (124/186) | 74% (42/57) | 60% (9/15) | 72% (23/32) | 100% (4/4) | 60% (46/78) |
Decreased penicillin susceptibility | 6% (10/183) | 7% (4/57) | 7% (1/14) | 0% (0/32) | 0% (0/4) | 7% (5/75) |
Death during hospitalisation | 21% (39/187) | 7% (4/57)** | 33% (5/15) | 26% (12/33) | 50% (2/4) | 21% (16/78) |
1. Neurological causes# | 8% (16/187)$ | 3.5% (2/57) | 13% (2/15) | 12% (4/33) | 0% (0/4) | 10% (8/78) |
2. Systemic causes¤ | 5% (9/187)$ | 0% (0/57) | 13% (2/15) | 9% (3/33) | 25% (1/4) | 4% (3/78) |
3. Other causes& | 2% (3/187) | 0% (0/57) | 0% (0/15) | 9% (3/33) | 0% (0/4) | 0% (0/78) |
Combination of 1 and 2 | 6%(11/187)$ | 3.5% (2/57) | 7% (1/15) | 6% (2/33) | 25% (1/4) | 7% (5/78) |
Sequelae | 41% (57/138) | 54% (26/48) | 22% (2/9) | 45% (9/20) | 100% (1/1) | 32% (19/60) |
1. Hearing loss | 24% (34/138) | 33% (16/48) | 11% (1/9) | 20% (4/20) | 0% (0/1) | 22% (13/60) |
2. Neurologic abnormalityˆ | 16% (22/138) | 21% (10/48) | 11% (1/9) | 25% (5/20) | 100% (1/1) | 8% (5/60) |
Combination of 1 and 2 | 1% (1/138) | 0% (0/48) | 0% (0/9) | 0% (0/20) | 0% (0/1) | 2% (1/60) |
Number of days hospitalised among survivors | 13 (10–20) | 13 (10–19) | 11 (10–36) | 22 (13–32) | 44 | 13 (11–16) |