Pneumococcal infections meningitis

Penicillin is the dmg of choice for the treatment of group B streptococcal, meningococcal and pneumococcal infections but, as discussed earlier, CSF concentrations of penicillin are significantly influenced by the intensity of the inflammatoiy response. To achieve therapeutic concentrations within the CSF, high dosages are required, and in the case of pneumococcal meningitis should be continued for 10-14 days. 

Respiratory symptoms, cough and hemoptysis may occur due to pulmonary infiltrates of Salmonella typhi and secondary pneumococcal infection. Bacteremia leads to focal disease, which presents with osteomyelitis, endocarditis, particularly in valvular disease, meningitis, soft-tissue abscesses, glomerulonephritis and skin lesions. CNS complications, such as meningitis, mental disturbances, delirium or depressed level of consciousness may occur in severe cases. 

Natural penicillin Infections like streptococcal pneumonia, enterococcal and nonenterococcal group D endocarditis, diphtheria, anthrax, meningitis, tetanus, botulism, actinomycosis, syphilis, and relapsing fever, Lyme disease prophylaxis against pneumococcal infections, rheumatic fever, bacterial endocarditis... 

Streptococcus pneumoniae is the most common bacterial cause of community-acquired respiratory tract infections. S. pneumoniae causes approximately 3000 cases of meningitis, 50,000 cases of bacteremia, 500,000 cases of pneumonia, and over 1 million cases of otitis media each year. The increasing prevalence of drug-resistant S. pneumoniae has highlighted the need to prevent infection through vaccination. Both licensed pneumococcal vaccines are highly effective in preventing disease from the common S. pneumoniae serotypes that cause human disease. 

Kozar, M. Krahmer, M. Fox, A. Gray, B. M. Failure to detect muramic acid in normal rat tissues but detection in cerebrospinal fluid from patients with pneumococcal meningitis. Infect. Immun. 2000, 68, 4688 1698. 

The Gram-positive bacterium Streptococcus pneumoniae is an important cause of respiratory tract infections, bacteremia, and meningitis. In this strain, the cell wall anchored pneumococcal surface protein A (PspA) has been demonstrated to bind lactoferrin [181]. PspA and closely related proteins in a variety of pneumococcal isolates are most likely involved in the sequestration of iron from lactoferrins, and finally contribute to the virulence of these bacteria. However, the means by which the pneumococcus acquires iron at the mucosal surface during invasive infection is not well understood at the molecular level [182],... 

Salmonella and Haemophilus infections and meningococcal and pneumococcal meningitis. 

Knowledge of the likely pathogens (and their current local susceptibility rates to antimicrobials) in the clinical situation. Thus cephalexin may be a reasonable first choice for lower urinary tract infection (coliform organisms — depending on the prevalence of resistance locally), and benzylpenicillin for meningitis in the adult (meningococcal or pneumococcal). 

Bass R, Engelhard D, Trembovler V, Shohami E (1996) A novel nonpsychotropic cannabinoid, HU-211, in the treatment of experimental pneumococcal meningitis. J Infect Dis 173 735-738... 

Kaplan SL. Management of pneumococcal meningitis. Pediatr Infect Dis 12002 21 589-591. 

For parenteral therapy of sensitive isolates, penicillin G or penicillin G procaine is favored. Therapy should be continued for 7—10 days, including 3—5 days after the patient is afebrile. Similarly, pneumococcal meningitis initially should be treated with a combination of vancomycin and a third-generation cephalosporin until it is established that the infecting pneumococcus is penicillin-sensitive. Recommended therapy is 20—24 million units of penicillin G daily by constant intravenous infusion or divided into boluses given every 2—3 hours for 14 days. 

C. Clinical Uses Because of its toxicity, chloramphenicol has very few uses as a systemic drug. It is a backup drug for severe infections caused by salmonella and for the treatment of pneumococcal and meningococcal meningitis in beta-lactam-sensitive persons. Some H influenzae strains are... 

Emonts M, Hazelzet JA, de Groot R, Hermans PW 2003 Host genetic determinants of Neisseria meningitidis infections. Lancet Infect Dis 3 565—577 Enders A, Pannicke U, Berner R et al 2004 Two siblings with lethal pneumococcal meningitis in a family with a mutation in Interleukin-1 receptor-associated kinase 4. J Pediatr 145 698-700... 

Data from the 1950s suggested that the tetracyclines can reduce the effectiveness of penicillins in the treatment of pneumococcal meningitis and probably scarlet fever. It is uncertain whether a similar interaction occurs with other infections. This interaction may possibly be important only with those infections where a rapid kill is essential. 

Documentation is limited, but this is an apparently important interaction when treating pneumococcal meningitis and probably scarlet fever as well. However, the use of these antibaeterials for sueh severe infections has largely been superseded. It has not been shown to oeeur when treating pneumococcal pneumonia. It has been suggested that antagonism, if it occurs, may only be significant when it is essential to kill baeteria rapidly, ... 

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