Features at admission associated with mortality (Table 5, page 1395):
(1) coma (relative risk 4.1, 95% CI 1.7 – 9.7)
(2) respiratory distress (relative risk 25.5, 95% CI 3.5 – 185.4)
(3) shock (relative risk 7.2, 95% CI 3.0 – 17.5)
(4) CSF protein level >= 2.5 g/L (relative risk 7.7, 95% CI 1.8 – 33.5)
(5) peripheral WBC count < 5 * 10^9 (< 5,000 per µL) (relative risk 5.6, 95% CI 1.0 – 8.8)
(6) serum sodium < 135 mmol/L (relative risk 11.0, 95% CI 1.5 – 80.4)
where:
• respiratory distress was associated with the need for artificial ventilation
Neurological sequelae following pneumococcal meningitis:
(1) hearing impairment
(2) hydrocephalus
(3) convulsions
(4) mental retardation
(5) paresis or spasticity
(6) cranial nerve abnormalities
Features at admission associated with sequelae (page 1394):
(1) presence of shock (relative risk 3.2, 95% CI 2.2 – 4.6)
(2) CSF glucose < 0.6 mmol/L (relative risk 2.9, 95% CI 1.4 - 6.0)
(3) CSF WBC count < 1,000 per µL (relative risk 1.6, 95% CI 1.0 – 2.7)
where:
• Coma is listed in the abstract as being associated with sequelae while shock is not.
• Another study (Bohr et al. J Infect. 1985; 10: 143-157) showed increased sequelae when the CSF WBC count was very high (>5,000 per µL).
• Treatment with steroids was not listed.
Children often die of neurological sequelae, while adults tend to die from cardiorespiratory failure associated with underlying diseases.
