Clinical Features of 8 Children with Bacterial Meningitis Caused by Streptococcus pneumoniae(Papers for cerebrating the Forty Aniversary of the Department of Pediatrics, Tokyo Women\u27s Medical University Center East)

Between January 1982 and March 2002, 7 children with bacterial meningitis caused by Streptococcus pneumoniae we were treated in our hospital. Patient background, laboratory data, treatment, antibiotic sensitivity, and complications were compared between the group with a good outcome and the group with a poor outcome. The risk factors for a poor outcome and an annual transition of resistant strains were examined. The following risk factors were found to be associated with a poor prognosis: low leukocyte count, high protein level and low glucose level in the initial cerebrospinal fluid specimen, complication by DIC, need for artificial ventilation, prolonged convulsions, and resistant strains. There have been many reports of infection by resistant strains since the 1990s, and the same trend was observed in our hospital. The treatment of first choice for penicillin-resistant Streptococcus pneumoniae is Panipenem/Betamipron. The outcome in two of our cases was poor despite the use of Panipenem/Betamipron. Because it is difficult to diagnose meningitis based only on the initial symptoms, careful examination, including a cerebrospinal fluid examination, and careful patient management are required. Streptococcus pneumoniae will probably become resistant to more antibiotics, and appropriate use of antibiotics for the treatment of bacterial infection may be needed.東京女子医科大学東医療センター小児科開局40周年記念論文