What Is Pneumococcal Meningitis?

Pneumococcal meningitis is a type of bacterial meningitis, a serious infection of the meninges, membranes that surround the brain and spinal cord. Pneumococcal meningitis is caused by specific bacteria: Streptococcus pneumoniae (S. pneumoniae). This is the most common cause of bacterial meningitis in adults and the second most common type of meningitis in kids who are older than 2.

Although meningitis cases are rare, pneumococcal meningitis accounts for half of all cases in the United States, about 2,000 cases annually. Pneumococcal meningitis is extremely serious: it kills 8% of children and 22% of adults who contract it. If you suspect that you might have pneumococcal meningitis, it’s important to seek treatment immediately. Here’s everything you should know about pneumococcal meningitis. 

Pneumococcal Meningitis Symptoms

The primary symptoms of meningitis include:

• Fever, especially high fever
• Headache
• Stiff neck

You might also experience:

• Sensitivity to light
• Confusion
• Trouble waking up from sleep, or feelings of excessive sleepiness
• Nausea and vomiting 
• Dizziness

Bacterial meningitis, including pneumococcal meningitis, also causes focal symptoms: those that affect a certain area of the body. These can include:

• Vision changes
• Difficulty moving, feeling, or controlling a limb or side of your face
• Hearing changes 

Children and babies who have meningitis might experience sleepiness, trouble eating, irritability, and bulging in the soft spot on the head. 

Causes

Pneumococcal meningitis occurs when bacteria enter the meninges—usually after passing through the bloodstream—and cause an infection. Once the meninges have become infected, blood vessels in the brain become damaged, which can allow the bacteria to enter the cerebrospinal fluid, causing further damage.

People can carry the S. pneumoniae bacteria without contracting an infection like meningitis or other pneumococcal disease, like pneumonia. In fact, most kids will be carriers of S. pneumoniae at some point without getting sick.

Scientists aren’t sure why some people get sick from S. pneumoniae while others are carriers who do not experience any symptoms of pneumococcal disease.

However, there are certain factors associated with a higher risk for pneumococcal meningitis.

• Alcohol use
• Diabetes
• Head trauma or injury
• History of meningitis
• Recent upper respiratory infection
• Recent S. pneumoniae infection, including in the ears, lungs, or heart
• A recent case of meningitis with other causes, especially if you have leaked spinal fluid
• Having had the spleen removed or having one that has reduced function (this can impact your immune system)

Diagnosis

If you are experiencing symptoms of meningitis, your healthcare provider will speak to you about:

• Your symptoms
• Exposure to other people with these symptoms
• Possible causes for your infection

They’ll examine your eyes and ears to look for signs of infection, which may have progressed to meningitis. 

Ultimately, if your provider believes that you have meningitis, they’ll want to conduct a spinal tap—also known as a lumbar puncture—to confirm and to identify which type of meningitis you have. During this procedure, a small amount of spinal fluid is removed from your lower spine. It can then be tested in the lab for bacteria, including S. pneumoniae. This can confirm the diagnosis of meningitis. 

Treatment

It’s critical to start treatment for pneumococcal meningitis immediately. The sooner treatment starts, the less likely you are to experience ongoing symptoms or to develop a fatal case of meningitis.

Pneumococcal meningitis is treated using antibiotics, which are usually given via an IV:

The first medication used is ceftriaxone. Ceftriaxone is effective even against bacteria that are resistant to other forms of antibiotics. If you don’t quickly show signs of improvement, your healthcare providerwill likely move on to other antibiotics.

Vancomycin or rifampin may be used if the first medication is not successful in treating symptoms. These antibiotics are also used to treat tuberculosis (TB).

In some cases, healthcare providers will also prescribe corticosteroids. These can help control pain, and help your body fight off the infection. It’s particularly common to use corticosteroids for children who have pneumococcal meningitis. 

Prognosis and Coping

Pneumococcal meningitis is a very serious condition. It kills 22% of adults and 8% of children who contract it.

For others, pneumococcal meningitis can cause lifelong health impacts. One in five people who recover from meningitis have lifelong effects. However, if you get treatment quickly, you’re less likely to die or have long-lasting side effects. 

If you recover from a serious case of pneumococcal meningitis, you might experience:

• Hearing loss (temporary or permanent)
• Changes to your vision
• Memory loss
• Behavioral or emotional problems

If you have experienced pneumococcal meningitis, you should speak with your healthcare provider about therapies that can help your recovery long term. These might include working with a physical therapist, speech and language pathologist, or neuropsychologist to help recover some or all of your previous functions. 

Prevention

There are four recommended vaccines that can reduce your risk of contracting pneumococcal meningitis:

• PCV13 (Prevnar 13)
• PCV15 (Vaxneuvance)
• PCV20 (Prevnar 20)
• PPSV23 (Pneumovax 23)

The Centers for Disease Control and Prevention (CDC) vaccination schedule recommends a four-dose series of either PCV13 and PCV15, starting at 2 months old. For adults, the recommended vaccine may depend on your age group, vaccine history, or if you have a certain medical condition. Talk to your healthcare provider to determine whether the vaccine is right for you or your child.

In addition to getting your vaccination, you can prevent the spread of S. pneumoniae through good hygiene practices, including properly washing your hands and covering coughs and sneezes. 

Summary

Pneumococcal meningitis occurs when S. pneumoniae bacteria infect the lining of the spinal cord or brain. This type of bacterial meningitis is among the most common, but also the most serious.

It’s often deadly, and 20% of people who survive experience lifelong impacts including brain damage and changes to their sight and hearing. However, the sooner you start treatment, the less likely you are to have a serious case.

A Word From Verywell 

If you or a loved one is recovering from pneumococcal meningitis, be sure to advocate for yourself. Appropriate therapies—like physical therapy and counseling—can help you recover some or all of your functions.