Fatal pneumococcal meningitis: failure of acute care focus of medical practice.

A 27-year-old soldier with a childhood history of splenectomy died as a result of pneumococcal meningitis. There was no documentation of pneumococcal vaccine in his 8-year military medical record. In light of the soldier's 58 documented encounters with the military medical system, this fatal case illustrates the health care system's failure because of its focus on acute care medicine. Health care that addresses only the medical management of acute illnesses and injuries allows this type of fatal case to occur, because preventive measures are ignored. Comprehensive health care must focus on wellness and emphasize prevention, including risk factor identification and reduction, education and counseling, screening for early signs of illness, optimization of mental and emotional health, and maintenance of appropriate immunizations and other preventive and therapeutic countermeasures. Overcoming the limited medical focus on acute care of illnesses/injuries and implementing comprehensive health care require changes in the culture of both civilian and military medicine.