| Recurrent Pneumococcal Meningitis |
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Suk Kyu Kim, Seung Wook Lee, Dong Hak Shin, Jip Kim |
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Dept, of Pediatrics Presbyterian Hospital, Taegu Korea |
| Recurrent Pneumococcal Meningitis |
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金錫圭, 李承郁, 申東觀, 金準 |
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大邱 東山基督病院 小兒科 |
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| Abstract |
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A case of pneumococcal meningitis which showed five times of recurrence was observed. Although several authers reported that the underlying factor of recurrent pneumococcal meningitis is to be defect of the skull or dura, there, at this case, was a large opening about lmm in diameter at tegmen tympani, which was found at the fifth hospital admission. It has clinically shown that about half of recurrent cases, the causes have been unknown. It is difficult to find out the cause. In bacteriological diagnosis, the culture of CSF is the factor of the bacteriological diagnosis. In blood culture 50% turned out to be positive but bacterial culture in the upper respiratory tract doesn’t help in making a diagnosis. About half of recurrent pneumococcal meningitis has been seen in infant and children. The mortality rate of infant and children is lower than adult, but the sequela is more frequent and severe. For the treatment removeing of underlying factor is important. Penicillin is drug of choice. Recommended treatment is to use both penicillin and sulfonamide for at least 2-3 weeks. It is better to avoid using penicillin and chloramphenicol together. Corticosteroid hormone doesn’t affect on the mortality rate, but has been proved to be effective in preventing sequela.
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