Re: Moroti et al. Recurrent pneumococcal meningitis

[摘要] We read the publication on “Predisposing conditions and outcome in adult patients with recurrent pneumococcal meningitis” with great interest. Based on their study of 182 patients, Moroti et al. concluded that “Patients with recurrent pneumococcal meningitis were younger, had less comorbidities and a better outcome”.1 The result in this report is in contrast with a previous report by de María Ugalde-Mejía et al., who studied in a neurosurgical center and noted that the patients had different predisposing factors with severe disease and high mortality.2 In the report by Moroti et al.1, it would be of interest to reassess the outcome according to neurosurgical and non-neurosurgical cases. We agree with Moroti et al. that identifying underlying predisposing conditions in patients with recurrent meningitis is useful for prevention for further episodes. Nevertheless, the better option might be giving the pneuomococcal vaccination.3 The vaccination is suggested for any cases with important overt risk factors such as CSF leakage and the vaccination is recommended before existence of any episode of infection.2 Finally, it is a simple but important concern that there is a possibility of false positive in case diagnosis.4,5 Enterococcus faecalis meningitis may be easily mis-diagnosed as pneumococcal meningitis.

[学科分类] 精神健康和精神病学