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Pathogenesis and Pathophysiology of Pneumococcal Meningitis
Open accessAbstract
Pneumococcal meningitis continues to be associated with high rates of mortality and long-term neurological sequelae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae, which must avoid mucosal entrapment and evade the host immune system after local activation. During invasive disease, pneumococcal epithelial adhesion is followed by bloodstream invasion and activation of the complement and coagulation systems. The release of inflammatory mediators facilitates pneumococcal crossing of the blood-brain barrier into the brain, where the bacteria multiply freely and trigger activation of circulating antigen-presenting cells and resident microglial cells. The resulting massive inflammation leads to further neutrophil recruitment and inflammation, resulting in the well-known features of bacterial meningitis, including cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, and cerebrovascular complications. Experimental animal models continue to further our understanding of the pathophysiology of pneumococcal meningitis and provide the platform for the development of new adjuvant treatments and antimicrobial therapy. This review discusses the most recent views on the pathophysiology of pneumococcal meningitis, as well as potential targets for (adjunctive) therapy.
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“In cases of bacterial meningitis, infections usually start as skin, gastrointestinal or respiratory infections that spread to the blood”
From Living on the Edge of the CNS: Meninges Cell Diversity in Health and Disease (2021) · cites this paper as Mook-Kanamori et al., 2011
In the citing paper
“Bacterial presence in the meninges induces a strong inflammatory response, including production of multiple cytokines (tumor necrosis factor (TNF)-alpha, interleukin (IL)-1-beta, and IL-6), and a massive infiltration of neutrophils”
From Living on the Edge of the CNS: Meninges Cell Diversity in Health and Disease (2021) · cites this paper as Mook-Kanamori et al., 2011
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ПРОБЛЕМА ПНЕВМОКОКОВИХ МЕНІНГІТІВ ЯК НАЙБІЛЬШ НЕБЕЗПЕЧНОЇ ІНВАЗИВНОЇ ФОРМИ ПНЕВМОКОКОВИХ ІНФЕКЦІЙ
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Metadata
- Authors
- Mook-Kanamori, B. B., Geldhoff, M., van der Poll, T., & van de Beek, D.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Department of Neurology and Center for Experimental and Molecular Medicine (CEMM), Center of Infection and Immunity Amsterdam (CINIMA), Academic Medical Center, P.O. Box 22660, 1100DD Amsterdam, The Netherlands
- Venue
- Clinical Microbiology Reviews
- Publisher
- American Society for Microbiology
- Published
- 2011-07
- Volume
- 24
- Issue
- 3
- Pages
- 557-591
- ISSN
- 0893-8512 (ISSN-L)
- 1098-6618
- PMC
- PMC3131058
- OpenAlex
- W2171827842
- Cited by
- 492
- References
- 569
- Citations by year
- 2026: 13 · 2025: 33 · 2024: 32 · 2023: 28 · 2022: 29 · 2021: 45 · 2020: 48 · 2019: 38 · 2018: 22 · 2017: 28 · 2016: 46 · 2015: 37 · 2014: 39 · 2013: 24 · 2012: 27
- FWCI
- 3.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Microbiology Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
- Keywords
- pneumococcal meningitis, Streptococcus pneumoniae, pathogenesis, pathophysiology, nasopharyngeal carriage, epithelial cell adhesion, blood-brain barrier penetration, complement activation, coagulation, microglia, neutrophil recruitment, cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, cerebrovascular complications, animal models, adjunctive therapy, antimicrobial therapy
- MeSH terms
- Animals, Humans, Inflammation, Meningitis, Pneumococcal, Streptococcus pneumoniae
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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