van de Beek Diederik, de Gans Jan, Spanjaard Lodewijk, Sela Shlomo, Vermeulen Marinus, Dankert Jacob
Department of Neurology, Academic Medical Center, and The Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam, The Netherlands.
Clin Infect Dis. 2002 May 1;34(9):e32-6. doi: 10.1086/339941. Epub 2002 Apr 4.
Chart review of 41 adult patients with group A streptococcal (GAS) meningitis in The Netherlands revealed that this is a community-acquired disease and occurs mainly in patients with predisposing factors: of the 41 patients in this case series, 24 (60%) of 40 evaluable patients had otitis or sinusitis. Fever and neck stiffness were the most common clinical manifestations of disease, but, in addition, high rates of seizures (12 [32%] of 38 patients), focal neurological findings (13 [36%] of 36 patients), and hyponatremia (20 [58%] of 35 patients) were found. In contrast with data from the literature that describes 27 adult cases, we found that GAS meningitis is a fulminant disease with a mortality rate of 27% (10 of 37 patients), and that neurological sequelae occur in 36% (12 of 38) of surviving patients.
对荷兰41例成人A组链球菌（GAS）脑膜炎患者的病历回顾显示，这是一种社区获得性疾病，主要发生在有易感因素的患者中：在该病例系列的41例患者中，40例可评估患者中有24例（60%）患有中耳炎或鼻窦炎。发热和颈部僵硬是该病最常见的临床表现，但此外，还发现癫痫发作率高（38例患者中有12例[32%]）、局灶性神经学表现（36例患者中有13例[36%]）和低钠血症（35例患者中有20例[58%]）。与描述27例成人病例的文献数据相比，我们发现GAS脑膜炎是一种暴发性疾病，死亡率为27%（37例患者中有10例），36%（38例中的12例）存活患者出现神经后遗症。
