Case Series of Pneumococcal Meningitis in the Post 13-valent Pneumococcal Conjugate Vaccine Era

Streptococcus pneumoniae is a leading cause of meningitis. Although rates of bacterial meningitis have decreased after pneumococcal conjugate vaccine introduction, pneumococcal meningitis has not been eliminated. In this case series, we describe the presentation, serotypes, and outcomes of 11 children with pneumococcal meningitis at a tertiary children's hospital after the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced, from 2011-2013. The median age of children with meningitis was 7 years. The majority of the isolates (82%) were susceptible to penicillin. Most isolates (73%) were serotyped and there was no evidence of disease caused by serotypes contained in PCV7. Only two patients had disease caused by serotypes contained in PCV13 and neither of these patients was eligible to receive PCV13. Significant findings from our study include: lack of documented fever in a portion of patients admitted with meningitis, older age of children with pneumococcal meningitis, and no evidence of PCV7 serotypes causing invasive disease.


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