Streptococcus pneumoniae is the leading cause of bacterial meningitis in the United States and accounts for significant morbidity and mortality in essentially all age groups. Prompt recognition and treatment can improve outcomes. In this article, the author reviews the clinical manifestations of S pneumoniae infection, with emphasis on neurologic symptoms and key features that can help avoid pitfalls leading to missed or late diagnosis. Current diagnostic laboratory techniques are evaluated, and up-to-date treatment recommendations based on the most recent research and expert opinion are incorporated. Recent research regarding the importance of endocarditis and bacteremia to neuropathogenesis, as well as the effect of bacterial meningitis on neurogenesis, is presented.
Historical note and terminology
In 1881, Streptococcus pneumoniae was identified simultaneously by Pasteur in France, who named it Microbe septice mique du salive, and by Sternberg in the United States, who called it Micrococcus pasteuri. By the late 1880s, the term pneumococcus had come into general use because of the association between this organism and lobar pneumonia. In 1926, the term Diplococcus was assigned because of the organism's appearance in gram-stained sputum. Finally, in 1974, the organism was renamed, Streptococcus pneumoniae because of its morphology during growth in liquid medium (Watson et al 1993; Musher 2000).
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