Pneumococcal meningitis is an inflammation or infection of the membranes covering the brain and spinal cord caused by Streptococcus pneumoniae (also called pneumococcus).

Streptococcus pneumoniae is the most common cause of meningitis in adults, and the second most common cause of meningitis in children older than age 6.

The onset of symptoms is usually rapid. Risk factors include recurrent meningitis, meningitis associated with leakage of spinal fluid, diabetes, injury or trauma to the head, alcohol use, recent pneumonia, recent upper respiratory infection, infection of a heart valve, spleen removal, or recent ear infection. About 15,000 cases occur in the United States each year.

• High fever
• Severe headache
• Nausea and vomiting
• Stiff neck
• Sensitivity to light (photophobia)
• Mental status changes

Physical examination will reveal a fast heart rate, high temperature, stiff neck, and cloudy mental status.

The following tests may be performed:

• Spinal tap will show white blood cells in the spinal fluid (CSF), often with elevated protein and low glucose.
• Gram stain of CSF will show white blood cells and sometimes gram-positive bacteria (pneumococcus).
• CSF culture may grow pneumococcus.
• Blood culture may grow pneumococcus.
• A CT scan of the brain, if done, is usually normal.