Prehospital diagnostic and therapeutic management of otogenic Streptococcus pneumoniae meningitis

Scandinavian Journal of Infectious Diseases
Christian ØstergaardSusanne Samuelsson

Abstract

Prehospital diagnostics and therapeutic management, as well as clinical and laboratory data from 57 consecutive cases with otogenic pneumococcal meningitis (OPM) in Denmark during a 2-y period (1999-2000) were studied by review of discharge and medical records including a questionnaire sent to the general practitioners responsible for the individual patient. 12 cases were <2 y of age, whereas the remaining 45 cases were >21 y of age. Fever (in 98%) and altered consciousness (in 98%), respectively, were significantly more frequent prehospital symptoms (median duration of symptoms: 2 d (1-4)) than earache (in 71%, p < 0.0001), tympanic perforation (in 38%, p < 0.0001), and back rigidity (in 25%, p < 0.0001) in OPM. Some 82% visited a physician before admission, and an otogenic focus was diagnosed in 57%, a myringotomy was performed in 12%, and antibiotic therapy was initiated in 29% of these cases. Prehospital antibiotic therapy was more likely to be initiated in patients where the physician found an otogenic focus compared to patients where an otogenic was not found (46% vs 6%, respectively, p = 0.01). However, <10% of cases with OPM were treated for otitis media with adequate dosing of antibiotics for more than 1 d based on pha...Continue Reading

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Citations

Nov 19, 2010·Scandinavian Journal of Infectious Diseases·Harpa Maria Ingolfsdottir, Per Cayé-Thomasen
Oct 16, 2009·Expert Opinion on Pharmacotherapy·M KleinU Koedel
Apr 17, 2013·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·S PalmaA Martini
Mar 24, 2009·Scandinavian Journal of Infectious Diseases·Olga DzupovaJiri Benes

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