Pneumococcal meningitis in infants.

A review and follow-up study of 21 Chinese infants who had pneumococcal meningitis showed a mortality of 23.8% and high morbidity in survivors. Severe meningitis and delay in treatment as reflected by the presence of coma, pneumonia, disseminated intravascular coagulation, and lumbar CSF protein of over 368 mg% and glucose of lower than 10 mg% at the time of diagnosis were associated with fatality. Although the pneumococcus was sensitive to Penicillins which were given at usually recommended dosages and duration in these infants, the morbidity in survivors was high, and seemed to be associated with the presence of focal neurological abnormalities at the time of diagnosis, slow response in fever to treatment, short duration of afebrile period before discontinuation of antibiotics, and incompletely normal CSF parameters at the time of cessation of antibiotics. Serially sterile lumbar CSF did not guarantee against recrudescence of meningitis after cessation of antibiotics. The lack of uniformity in treating and monitoring these patients and suggested management are discussed.