Introduction

Pneumococcal meningitis is a life-threatening infectious disease that causes inflammation of the membranes which surround the brain and the spinal cord. These membranes are called the meninges (protect the brain from injury and infection).

Pneumococcal meningitis is caused by the bacterium called Streptococcus pneumoniae bacteria (it can also be called pneumococcus, or S. pneumoniae). This type of bacteria is the most common cause of bacterial meningitis in adults and the second most common cause of meningitis in children under the age of 2 years.

What are the Symptoms of Pneumococcal Meningitis?

Occasionally pneumococcal bacteria take over the body’s defenses and cause infection. Bacteria are usually transferred to the meninges via the bloodstream. When the bacteria infect the meninges, tiny blood vessels in the membranes are damaged. This allows the bacteria to break through and infect the cerebrospinal fluid (CSF). The meninges then become inflamed and pressure around the brain can cause nerve damage. Pressure on the brain can produce the specific symptoms associated with meningitis:

• Severe headache
• Sensitive to bright lights (photophobia)
• Neck stiffness
• Nausea and vomiting
• Confusion and drowsiness
• Loss of consciousness
• Seizures

Other symptoms that can occur with pneumococcal meningitis include:

• Agitation
• Bulging fontanelles in infants
• Decreased consciousness
• Poor feeding or irritability in children
• Rapid breathing
• Unusual posture with the head and neck arched backwards (opisthotonos)

It is important to note that Pneumococcal meningitis is an important cause of fever in infants.

What are the Causes and Risk Factors Associated with Pneumococcal Meningitis?

Pneumococcal meningitis can affect any age group, but those affected the most are children and adults with conditions affecting the immune system, especially humoral immunity. Such conditions include; sickle cell anaemia, immunodeficiency diseases associated with malnutrition, and certain cancers. Such people are prone to pneumococcal pneumonia.

Causes of Pneumococcal Meningitis

Pneumococcal meningitis occurs when the bacteria S. pneumoniae enters a person’s bloodstream and infects the meninges. And this bacterium can also cause other illnesses like:

• Pneumonia
• Sinus infections
• Blood infections
• Ear infections

The bacteria spreads via tiny droplets which are released from a person’s nose or mouth. These droplets may come into contact with another person via:

• Coughing
• Sneezing
• Sharing of food

Risk Factors

Certain factors can make a person more susceptible to developing pneumococcal meningitis, including:

• The decreased immune response from infection, drug use or immunodeficiency
• Trauma or injury to the head
• Recent ear infection with  pneumoniae
• Removed or non-functioning spleen
• Chronic liver, lung, renal, or heart disease
• The recent case of pneumonia with  pneumoniae
• Children with conditions affecting the spleen, such as sickle cell, HIV, or AIDS, have a much higher risk of developing pneumococcal meningitis.
• People who live in close contact with many others may be more likely to contract pneumococcal meningitis. Residing in dorms or other communal living situations may increase a person’s risk of developing the condition. Children in daycare may also be at risk.

How Can Pneumococcal Meningitis Be Treated?

Tests can confirm a diagnosis of pneumococcal meningitis. It is generally diagnosed through a ‘Spinal Tap’ which is the collection of a sample of the fluid in the spine. This fluid is then tested for the presence of pneumococcal meningitis.

However, since pneumococcal meningitis can pose to be a serious threat to life, rapid admission to a hospital and urgent treatment with antibiotics can begin by medical doctors. Ceftriaxone is an antibiotic that is commonly used to treat pneumococcal meningitis but is often used along with other antibiotics.

Other possible antibiotics for pneumococcal meningitis include:

• Vancomycin
• Ampicillin
• Benzylpenicillin
• Cefotaxime
• Chloramphenicol
• Penicillin

Prevention of Pneumococcal Meningitis

There are two vaccines available to protect against different types of pneumococcal meningitis.

A Pneumococcal Conjugate Vaccine (PCV) is given to babies at 12 weeks and between 12 - 13 months. The Pneumococcal Polysaccharide Vaccine (PPV) is also available and offered to all people aged 65 years and above.

Both pneumococcal vaccinations are also recommended, when appropriate, for adults and children who are at increased risk of pneumococcal disease, for example, those with sickle cell anaemia. Anyone who has pneumococcal disease, including meningitis, should actively seek vaccination.