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June 1987

Pneumococcal Meningitis Complicated by Immune Complex–Mediated Arthritis

Author Affiliations

Pediatric Medicine Inc Pediatric Inc 1900 ational Suite 3200 Springfield, MO 65804

Am J Dis Child. 1987;141(6):603-604. doi:10.1001/archpedi.1987.04460060021014

Sir—.In a recent issue of the ARCHIVES, Likitnukul et al1 found arthritis to be a complication of Haemophilus influenzae and Neisseria meningiditisismeningitis in 3% to 4% of cases. Arthritis was not identified, however, in 179 cases of pneumococcal meningitis. We describe herein a patient with pneumococcal meningitis complicated by possible immune complex–mediated

Patient Report— A full-term male infant was born by cesarean section because of maternal preeclampsia and cephalopelvic disproportion. Membranes were ruptured for five hours prior to delivery, and there were no signs of maternal or fetal infection. Apgar scores were 8 at both one and five minutes. The infant remained well until the fourth day of life when irritability and a temperaure of 39.5°C Blood and cerebrospinal fluid specimens yielded Streptococcus pneumoniae susceptible to penicillin by oxacillin disk testing. Therapy with ampicillin and gentamicin was begun; the latter drug was discontinued the followingy. Repeated blood cultures obtained after two and five days of therapy were sterile, as were cerebrospinal fluid specimens examined after three days of treatment. His condition stabilized and his course

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