Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020

Meiring, Susan; Cohen, Cheryl; Gouveia, Linda de; Plessis, Mignon du; Quan, Vanessa; Kleynhans, Jackie; Menezes, Colin; Reubenson, Gary; Dawood, Halima; Nchabeleng, Maphoshane; Said, Mohamed; Mvelase, Nomonde R.; Mahabeer, Prasha; Chomba, Rispah; Lekalakala, Ruth; Nana, Trusha; Black, Marianne; Gottberg, Anne von

doi:10.1016/j.ijid.2022.07.068

Cited by 4 publications

(5 citation statements)

References 28 publications

(32 reference statements)

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“…The epidemiology of pneumococcal meningitis has changed since the introduction of pneumococcal vaccinations [ 5 , 10 ]. There is a decreased incidence of the infection of vaccine serotypes; however, the prevalence of non-vaccine serotypes has increased [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Complications following bacterial meningitis are mostly neurologic, including cerebral infarction, hemorrhage, abscess, and cerebral edema [ 2 ], and more uncommonly, cerebral venous thrombosis [ 4 ] where rapid progression to brain death can occur [ 2 , 4 ]. Clinical manifestations of these neurological sequelae include hearing loss, visual impairments, seizures, hydrocephalus [ 4 , 5 ], cognitive deficits [ 5 ], and increased intracranial pressure (ICP) [ 5 ]. Those with a history of trauma, immunosuppression, and other comorbidities are at a higher risk of developing complications, specifically the association of head injury and increased ICP [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical manifestations of these neurological sequelae include hearing loss, visual impairments, seizures, hydrocephalus [ 4 , 5 ], cognitive deficits [ 5 ], and increased intracranial pressure (ICP) [ 5 ]. Those with a history of trauma, immunosuppression, and other comorbidities are at a higher risk of developing complications, specifically the association of head injury and increased ICP [ 2 , 5 ]. Increased ICP is associated with pupillary abnormalities, especially in those with a history of brain or facial injury [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Rapidly Progressive Fatal Pneumococcal Meningitis in a Fully Immunized Child With a History of Facial Bone Fractures

Stanley,

Rizvi,

Sahhar

2024

Cureus

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Meningitis is the inflammation of meninges either septic or aseptic depending on the source of infection. Typical signs and symptoms of meningitis in children include fever, headache, neck stiffness, nuchal rigidity represented by positive Kernig and Brudzinski signs, photophobia, nausea, vomiting, confusion, lethargy, and irritability. Bacterial meningitis is commonly caused by Streptococcus pneumoniae in children over the age of three months. Although there has been a decline in infections due to the introduction of the pneumococcal conjugate and pneumococcal polysaccharide vaccines, there are still reported cases of invasive pneumococcal infections mostly with non-vaccine serotypes. We report a fully immunized six-year-old male patient with a presentation of classic meningitis signs and symptoms who developed rapid progression of disease including sudden and dramatic change in physical exam and subsequent respiratory depression within 12 hours of admission. Our patient had a history of extensive traumatic facial bone fractures six months prior. Our case demonstrates a unique presentation of rapidly progressing pneumococcal meningitis due to a suspected complication of septic thrombophlebitis and subsequent brain herniation in a fully immunized patient six months after a severe traumatic facial injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rapidly Progressive Fatal Pneumococcal Meningitis in a Fully Immunized Child With a History of Facial Bone Fractures

Stanley,

Rizvi,

Sahhar

2024

Cureus

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“…A study conducted in South Africa across 26 hospitals concluded that HIV infection, comorbidities, and altered mental status were risk factors for death as an outcome in patients with BM antimicrobial nonsusceptibility and impaired mental status were risk factors for negative sequelae [ 7 ]. A 50-year study in Sweden on the etiology, risk factors, disease trends, and severe sequelae concluded that following the introduction of the vaccination, the BM incidence in immunosuppressed individuals climbed by 3% yearly.…”

Section: Introductionmentioning

confidence: 99%

Outcomes, Symptomatology, and Mortality of Children Presenting With Bacterial Meningitis at Allied Hospitals of Rawalpindi Medical University, Pakistan: A Cross-Sectional Study

Zarak Khan,

Waheed,

Fazal

et al. 2024

Cureus

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Introduction Bacterial meningitis (BM) is a neurologic emergency mainly affecting children under the age of two. Clinical symptoms are rarely evident in children, thus making a diagnosis is a challenge. Antibiotic therapy should be started timely to ensure the avoidance of significant morbidity and mortality. This study aims to assess the outcomes, mortality, and symptomatology of children presenting with BM in allied hospitals of Rawalpindi Medical University, Pakistan. Methods It is a cross-sectional study employing a sample size of 201, conducted at the Allied Hospitals of Rawalpindi Medical University, Pakistan from a period of January 2023 to August 2023. Non-probability convenience sampling was used. Children aged between newborns and 14 years of age with a confirmed diagnosis of bacterial meningitis were included in this study. The study population was divided into five different age groups. Three different outcomes were studied including complete recovery, development of complications, and death. Data was entered into and analyzed by Statistical Package for the Social Sciences (SPSS) version 25 (IBM Corp., Armonk, NY, USA). Descriptive statistics were applied to the demographic data. The chi-square analytical test was applied to study the association between the categorical variables. Results One hundred nineteen (59.2%) of the study’s population were males. One hundred twenty-six (62.7%) of the patients were born through a spontaneous vaginal delivery (SVD). The majority (54%) of the study population were infants. Twenty-three percent were newborns, 13% were toddlers, 6% were preschool children, and 4% were school-age children. The majority (85%) of the study participants belonged to lower socioeconomic backgrounds. Ninety percent of the cases had symptoms of fever, seizures, and poor feeding. Neck stiffness was significantly associated with death as an outcome (p-value=0.01). The overall mortality amongst the study population was 20%. Forty-nine percent of the study population recovered completely, whereas 31% had complications following the diagnosis. Neonates had a higher mortality rate than infants (45% vs 9% respectively). Conclusion The most common presenting symptoms were fever, vomiting, seizures, and neck stiffness. Poor feeding was also seen in most cases. The rate of complications and death is observed to be relatively higher following the diagnosis of bacterial meningitis as compared to rates in the surrounding and developed countries. Out of all signs and symptoms, the presence of neck stiffness was significantly associated with death as an outcome among children with bacterial meningitis.

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“…It is estimated that about 1.2 million cases of bacterial meningitis (BM) occur annually worldwide. The case fatality rate associated with BM is between 19 to 37%, and most of them are children and young adults [3] . The most common bacterial causes of BM are Streptococcus pneumonia, Neisseria meningitidis, Haemophilus influenzae type b (Hib), and S. agalactiae.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Multiplex Quantitative Real-Time PCR and Culture Methods for the Diagnosis of Bacterial Meningitis in Patients with Suspected Meningitis

Ghafari,

Namakin,

khooban

et al. 2023

IEM

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Background: This study aimed to compare the diagnostic efficacy of standard culture method with multiplex quantitative real-time polymerase chain reaction (qPCR) in examining cerebrospinal fluid (CSF) samples collected from patients with suspected meningitis. Materials & Methods: A retrospective evaluation was conducted on 166 patients with suspected meningitis, who were treated in Vali-Asr hospital in Birjand, Iran between 2011 and 2020. Diagnosis of bacterial meningitis was based on CSF culture and multiplex qPCR results. Findings: Among 166 patients, conventional methods identified causative pathogens in only 10.3% of cases, while multiplex qPCR detected pathogens in eight out of 25 culture-negative cases as well. The most common pathogens identified were enterovirus, Epstein-Barr virus, herpes simplex, Haemophilus influenzae, and Streptococcus pneumoniae. Conclusion: Multiplex qPCR appears to be a more effective method than conventional culture in identifying bacterial and viral pathogens that most commonly cause meningitis. The incorporation of qPCR as a routine diagnostic method for meningitis in clinical practice could significantly enhance clinical decision-making and patient care.

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Case-fatality and sequelae following acute bacterial meningitis in South Africa, 2016 through 2020

Cited by 4 publications

References 28 publications

Rapidly Progressive Fatal Pneumococcal Meningitis in a Fully Immunized Child With a History of Facial Bone Fractures

Rapidly Progressive Fatal Pneumococcal Meningitis in a Fully Immunized Child With a History of Facial Bone Fractures

Outcomes, Symptomatology, and Mortality of Children Presenting With Bacterial Meningitis at Allied Hospitals of Rawalpindi Medical University, Pakistan: A Cross-Sectional Study

Comparison of Multiplex Quantitative Real-Time PCR and Culture Methods for the Diagnosis of Bacterial Meningitis in Patients with Suspected Meningitis

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