{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T12:17:52Z","timestamp":1772281072827,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2005,10,27]],"date-time":"2005-10-27T00:00:00Z","timestamp":1130371200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>We conducted a nationwide study in Denmark to identify clinical features and prognostic factors in patients with <jats:italic>Streptococcus pneumoniae<\/jats:italic> according to the focus of infection.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Based on a nationwide registration, clinical information's was prospectively collected from all reported cases of pneumococcal meningitis during a 2-year period (1999\u20132000). Clinical and laboratory findings at admission, clinical course and outcome of the disease including follow-up audiological examinations were collected retrospectively. The focus of infection was determined according to the clinical diagnosis made by the physicians and after review of the medical records.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>187 consecutive cases with <jats:italic>S. pneumoniae<\/jats:italic> meningitis were included in the study. The most common focus was ear (30%), followed by lung (18%), sinus (8%), and other (2%). In 42% of cases a primary infection focus could not be determined. On admission, fever and an altered mental status were the most frequent findings (in 93% and 94% of cases, respectively), whereas back rigidity, headache and convulsion were found in 57%, 41% and 11% of cases, respectively. 21% of patients died during hospitalisation (adults: 27% vs. children: 2%, Fisher Exact Test, <jats:italic>P<\/jats:italic> &lt; 0.001), and the causes of death were due to neurological \u2013 and systemic complications or the combination of both in 8%, 5% and 6% of cases, respectively. Other causes (e.g. gastrointestinal bleeding, incurable cancer) accounted for 2% of cases. 41% of survivors had neurological sequelae (hearing loss: 24%, focal neurological deficits: 16%, and the combination of both: 1%). The mortality varied with the focus of the infection (otogenic: 7%, sinusitic: 33%, pneumonic: 26%, other kind of focus: 50%, no primary infection focus: 21%, Log rank test: <jats:italic>P<\/jats:italic> = 0.0005). Prognostic factors associated with fatal outcome in univariate logistic regression analysis were advanced age, presence of an underlying disease, history of headache, presence of a lung focus, absence of an otogenic focus, having a CT-scan prior to lumbar puncture, convulsions, requirement of assisted ventilation, and alterations in various CSF parameters (WBC &lt;500 cells\/\u03bcL, high protein levels, glucose levels&lt;1 mmol\/L, low CSF\/blood glucose levels), <jats:italic>P<\/jats:italic> &lt; 0.05. Independent prognostic factor associated with fatal outcome in multivariate logistic regression analysis was convulsions (OR: 4.53, 95%CI: (1.74\u201311.8), p = 0.002), whereas presence of an otogenic focus was independently associated with a better survival (OR: 6.09, 95%CI: (1.75\u201321.2), <jats:italic>P<\/jats:italic> = 0.005).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>These results emphasize the prognostic importance of an early recognition of a predisposing focus to pneumococcal meningitis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-5-93","type":"journal-article","created":{"date-parts":[[2005,10,28]],"date-time":"2005-10-28T06:14:08Z","timestamp":1130480048000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":95,"title":["Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection"],"prefix":"10.1186","volume":"5","author":[{"given":"Christian","family":"\u00d8stergaard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helle Bossen","family":"Konradsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Samuelsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2005,10,27]]},"reference":[{"key":"241_CR1","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1056\/NEJMoa021334","volume":"347","author":"J de Gans","year":"2002","unstructured":"de Gans J, van de Beek D: Dexamethasone in adults with bacterial meningitis. 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