Pneumococcal meningitis in sickle cell disease in childhood.

In a population of children with pneumococcal meningitis, 71 had hemoglobin electrophoresis, and 17 of these were found to have homozygous hemoglobin S (24%). These 17 children were compared with 19 similarly infected children who had hemoglobin A and were matched for age and duration of symptoms before treatment. There was no difference in the symptoms or laboratory data, except for the hematocrit value, but patients with fatal disease came to the hospital later than control patients. The mortality and morbidity were similar even though control patients had a wider range of serious sequelae. Although patients with homozygous hemoglobin S were shown to be much more susceptible to pneumococcal meningitis, they were not at an increased risk from its effects.