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Table 1 Characteristics of 187 patients with S. pneumoniae meningitis according to the focus of the infection.

From: Clinical presentation and prognostic factors of Streptococcus pneumoniae meningitis according to the focus of infection

% or median (25/75 percentiles) and (No/total) All cases
(N = 187)
Otogenic focus
(N = 57)
Sinusitic focus
(N = 15)
Pneumonic focus
(N = 33)
Other foci
(N = 4)
No primary infection focus
(N = 78)
Sex (female/male) 91/96 34/23 9/6 15/18 3/1 30/48
Age (in years) 55 (22–69) 56 (37–71) 66 (39–73) 58 (44–70) 75 (55–81) 49 (1–64)
<16 years of age 24% (45/187) 21% (12/57) 7% (1/15) 9% (3/33) 0% (0/4) 37% (29/78)
Predisposing condition* 12 % (23/185) 11% (6/57) 27% (4/15) 6% (2/33) 0% (0/4) 15% (11/76)
Underlying disease§ 18% (33/185) 14% (8/57) 20% (3/15) 36% (12/33) 25% (1/4) 12% (9/76)
Clinical features on admission       
   Fever 93% (155/166) 98% (55/56) 92% (12/13) 100% (27/27) 75% (3/4) 95% (63/66)
   Headache 41% (48/116) 44% (17/39) 63% (5/8) 40% (6/15) 0% (0/3) 39% (20/51)
   Back rigidity 57% (86/151) 65% (34/52) 75% (9/12) 41% (9/22) 25% (1/4) 54% (33/61)
   Decreased consciousness 94% (165/176) 98% (53/54) 86% (12/14) 93% (28/30) 100% (4/4) 92% (68/74)
Convulsion
(Debut before/
after admission)
31% (54/175)
11% (19/175)
17% (29/175)
23% (13/56)
5% (3/56)
18% (10/56)
33% (5/15)
20% (3/15)
13% (2/15)
41% (12/29)
10% (3/29)
31% (9/29)
50% (2/4)
0% (0/0)
50% (2/4)
31% (22/71)
14% (10/71)
17% (12/71)
   Duration of symptoms 2 days (2–4) (111/187) 2 days (1–4) (53/57) 3 days (2–7) (11/15) 3 days (2–8) (12/33) 3 days (1–5) (3/4) 2 days (2–3) (37/76)
Mechanical ventilation 58% (97/168) 49% (25/51) 50% (6/12) 77% (24/31) 100% (4/4) 54% (38/70)
CT-scan before lumbar puncture 11% (21/187) 7% (4/57) 13% (2/15) 12% (4/33) 0% (0/4) 14% (11/78)
Steroid therapy 16% (26/163) 14% (7/51) 8% (2/13) 19% (5/26) 0% (0/4) 17% (12/69)
Paraclinical findings CSF WBC (cells/μL) 1842 (291–4419) (149/187) 2844 (914–4553)## (50/57) 119 (41–5489) (12/15) 497 (66–2708) (24/33) 38 (1–235) (4/4) 2475 (850–4650)¤¤ (59/78)
   CSF protein (g/L) 2.7 (1.4–5.8) (123/187) 3.1 (1.7–5.9) (44/57) 4.0 (1.0–9.0) (10/15) 2.8 (1.0–6.0) (18/33) 8.2 (0.5–10) (3/4) 2.3 (1.3–4.4) (48/78)
   CSF glucose (mmol/L) 0.9 (0.4–2.8) (129/187) 0.9 (0.4–2.6) (45/57) 0.7 (0.1–3.0) (11/15) 0.9 (0.3–3.2) (21/33) 2.4 (0.6–3.7) (3/4) 0.9 (0.4–2.9) (49/78)
   CSF/blood glucose ratio 0.1 (0.04–0.4) (93/187) 0.1 (0.05–0.3) (29/57) 0.05 (0.01–0.4) (9/15) 0.07 (0.01–0.4) (18/33) 0.5 (0.09–0.9) (2/4) 0.2 (0.04–0.5) (35/78)
   Positive CSF culture 95% (176/186) 93% (53/57) 100% (15/15) 91% (29/32) 100% (4/4) 96% (75/78)
   Blood WBC (109 cells/L) 17.3 (10.5–25.7) (134/187) 17.6 (10.5–24.1) (29/57) 20.0 (8.9–26.2) (12/15) 12.6 (7.9–22.9) (23/33) 10.2 (6.7–19) (3/4) 17.9 (14.1–27.7) (50/78)
   Positive blood culture 67% (124/186) 74% (42/57) 60% (9/15) 72% (23/32) 100% (4/4) 60% (46/78)
   Decreased penicillin susceptibility 6% (10/183) 7% (4/57) 7% (1/14) 0% (0/32) 0% (0/4) 7% (5/75)
Death during hospitalisation 21% (39/187) 7% (4/57)** 33% (5/15) 26% (12/33) 50% (2/4) 21% (16/78)
   1. Neurological causes# 8% (16/187)$ 3.5% (2/57) 13% (2/15) 12% (4/33) 0% (0/4) 10% (8/78)
   2. Systemic causes¤ 5% (9/187)$ 0% (0/57) 13% (2/15) 9% (3/33) 25% (1/4) 4% (3/78)
   3. Other causes& 2% (3/187) 0% (0/57) 0% (0/15) 9% (3/33) 0% (0/4) 0% (0/78)
   Combination of 1 and 2 6%(11/187)$ 3.5% (2/57) 7% (1/15) 6% (2/33) 25% (1/4) 7% (5/78)
Sequelae 41% (57/138) 54% (26/48) 22% (2/9) 45% (9/20) 100% (1/1) 32% (19/60)
   1. Hearing loss 24% (34/138) 33% (16/48) 11% (1/9) 20% (4/20) 0% (0/1) 22% (13/60)
   2. Neurologic abnormalityˆ 16% (22/138) 21% (10/48) 11% (1/9) 25% (5/20) 100% (1/1) 8% (5/60)
   Combination of 1 and 2 1% (1/138) 0% (0/48) 0% (0/9) 0% (0/20) 0% (0/1) 2% (1/60)
Number of days hospitalised among survivors 13 (10–20) 13 (10–19) 11 (10–36) 22 (13–32) 44 13 (11–16)
  1. * Predisposing condition was defined a previous head trauma, liquorrhoea, dura disruption etc.
  2. §Underlying disease was defined as previous splenectomy, presence of immunodeficit, cancer, diabetes mellitus, alcoholism, or the use of immunosuppressive drugs.
  3. # Includes brain herniation, cerebrovascular complications.
  4. ¤ Includes septic shock, multiple-organ dysfunction.
  5. & Includes withdrawal of care due to incurable cancer (1 patient), gastrointestinal bleeding (+/- Bilroth II operation, 2 patients).
  6. ˆNeurologic abnormality was defined as presence of aphasia, ataxia and paresis at discharge.
  7. $ 1 patient also had gastrointestinal bleeding/Billroth II operation.
  8. ##Significant difference vs. sinusitic cases, pneumonic cases, and cases with other foci (Mann Whitney test with Bonferonis correction P < 0.05).
  9. ¤¤ Significant difference vs. sinusitic cases, and cases with other foci (P < 0.05).
  10. **Significant difference vs. pneumonic cases (Fisher Exact test with Bonferonis correction, P = 0.01).