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  • Title: Group a streptococcal meningitis in adults: report of 41 cases and a review of the literature.
    Author: van de Beek D, de Gans J, Spanjaard L, Sela S, Vermeulen M, Dankert J.
    Journal: Clin Infect Dis; 2002 May 01; 34(9):e32-6. PubMed ID: 11941569.
    Abstract:
    Chart review of 41 adult patients with group A streptococcal (GAS) meningitis in The Netherlands revealed that this is a community-acquired disease and occurs mainly in patients with predisposing factors: of the 41 patients in this case series, 24 (60%) of 40 evaluable patients had otitis or sinusitis. Fever and neck stiffness were the most common clinical manifestations of disease, but, in addition, high rates of seizures (12 [32%] of 38 patients), focal neurological findings (13 [36%] of 36 patients), and hyponatremia (20 [58%] of 35 patients) were found. In contrast with data from the literature that describes 27 adult cases, we found that GAS meningitis is a fulminant disease with a mortality rate of 27% (10 of 37 patients), and that neurological sequelae occur in 36% (12 of 38) of surviving patients.
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