College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai P.O. Box 505055, United Arab Emirates.
Faculty of Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland.
Int J Mol Sci. 2024 Oct 15;25(20):11053. doi: 10.3390/ijms252011053.
Streptococcus species represent a significant global cause of meningitis, leading to brain damage through bacterial virulence factors and the host inflammatory response. Upon entering the central nervous system (CNS), excessive inflammation leads to various neurological and psychological complications. This review explores the pathophysiological mechanisms and associated outcomes of streptococcal meningitis, particularly its short- and long-term neurological sequelae. Neurological symptoms, such as cognitive impairment, motor deficits, and sensory loss, are shown to vary in severity, with children being particularly susceptible to lasting complications. Among survivors, hearing loss, cognitive decline, and cranial nerve palsies emerge as the most frequently reported complications. The findings highlight the need for timely intervention, including neurorehabilitation strategies that focus on optimizing recovery and mitigating long-term disabilities. Future recommendations emphasize improving early diagnosis, expanding vaccine access, and personalizing rehabilitation protocols to enhance patient outcomes. As a novel contribution, this review proposes the term "post-meningitic syndrome" to showcase the broad spectrum of CNS complications that persist following streptococcal meningitis, providing a framework for a future clinical and research focus.
链球菌属是全球范围内导致脑膜炎的重要病因之一，其通过细菌毒力因子和宿主炎症反应导致脑损伤。进入中枢神经系统（CNS）后，过度炎症会导致各种神经和心理并发症。本综述探讨了链球菌性脑膜炎的病理生理机制及相关结局，特别是其短期和长期的神经后遗症。研究表明，神经症状如认知障碍、运动缺陷和感觉丧失的严重程度各不相同，儿童尤其容易出现持久的并发症。在幸存者中，听力损失、认知能力下降和颅神经麻痹是最常报告的并发症。研究结果强调了及时干预的必要性，包括神经康复策略，重点是优化恢复和减轻长期残疾。未来的建议强调了改善早期诊断、扩大疫苗接种和个性化康复方案的必要性，以改善患者的预后。作为一项新的贡献，本综述提出了“脑膜炎后综合征”这一术语，以展示链球菌性脑膜炎后持续存在的广泛的中枢神经系统并发症，为未来的临床和研究重点提供了一个框架。
