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Meningitis (pneumococcal)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Is an infection caused by a Gram-positive bacterium Streptococcus pneumoniae (commonly known as pneumococcus) (1)

  • encapsulated form of the organism is responsible for causing infections (pneumococci without the capsule is usually not virulent) (2)
  • organism is transmitted from person-to-person contact through aerosol, droplets or direct contact with respiratory secretions (1)

According to the affected site, penumococci may cause sinusitis, ottitis media, pneumonia or systemic (invasive) infections (bacteraemia and meningitis) (2).

Invasive pneumococcal disease (IPD) causes considerable morbidity and mortality especially in very young people, elderly people, in those with an absent or non functioning spleen and in immunosupressed patients (2).

With respect to meningitis when the causative organism is known (3):

  • for Streptococcus pneumoniae meningitis:
    • give ceftriaxone (use the highest doses recommended by the BNF or BNFC or refer to local antimicrobial guidance)
    • if ceftriaxone is contraindicated, consider cefotaxime (see the BNFC for contraindications to ceftriaxone for pre-term babies under 41 weeks corrected gestational age)
    • after 10 days, stop antibiotics if the person has recovered, or get advice from an infection specialist if they have not.


  • Streptococcus pneumoniae may on rare occasions cause clusters of serious disease including septicaemia, pneumonia and meningitis in closed settings such as hospitals, long-term care facilities, prisons, military settings and children’s day-care centres (1)
    • a suspect cluster is defined as two or more cases of serious pneumococcal disease occurring in a closed setting within a 14 day period (1).


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