Predisposition to pneumococcal meningitis
Vulnerability to strep pneumoniae meningitis is as follows:-
- pneumonia - in 15 to 25% of patients
- otitis media - in 30%
- sinusitis
- head injury, CSF fistula, leak - 10%
- alcoholism - cirrhosis with or without peritonitis - 20 to 35%
- sickle cell, thalassaemia
- nephrotic syndrome
- CLL
- asplenic states
- Wiskott-Aldrick syndrome
- multiple myeloma
- extremes of age.
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