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Meta-Analysis
. 2015 Oct 27;9(10):e0004191.
doi: 10.1371/journal.pntd.0004191. eCollection 2015.

Streptococcus suis Meningitis: A Systematic Review and Meta-analysis

Anusha van Samkar  1 , Matthijs C Brouwer  1 , Constance Schultsz  2 , Arie van der Ende  3 , Diederik van de Beek  1
Affiliations
Meta-Analysis

Streptococcus suis Meningitis: A Systematic Review and Meta-analysis

Anusha van Samkar et al. PLoS Negl Trop Dis. .

Abstract

Background: Streptococcus suis is the most common cause of meningitis in pork consuming and pig rearing countries in South-East Asia. We performed a systematic review of studies on S. suis meningitis to define the clinical characteristics, predisposing factors and outcome.

Methodology: Studies published between January 1, 1980 and August 1, 2015 were identified from main literature databases and reference lists. Studies were included if they were written in West-European languages and described at least 5 adult patients with S. suis meningitis in whom at least one clinical characteristic was described.

Findings: We identified 913 patients with S. suis meningitis included in 24 studies between 1980 and 2015. The mean age was 49 years and 581 of 711 patients were male (82%). Exposure to pigs or pork was present in 395 of 648 patients (61%) while other predisposing factors were less common. 514 of 528 patients presented with fever (97%), 429 of 451 with headache (95%), 462 of 496 with neck stiffness (93%) and 78 of 384 patients (20%) had a skin injury in the presence of pig/pork contact. The case fatality rate was 2.9% and hearing loss was a common sequel occurring in 259 of 489 patients (53%). Treatment included dexamethasone in 157 of 300 (52%) of patients and was associated with reduced hearing loss in S. suis meningitis patients included in a randomized controlled trial.

Conclusion: S. suis meningitis has a clear association with pig and pork contact. Mortality is low, but hearing loss occurs frequently. Dexamethasone was shown to reduce hearing loss.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow-chart systematic review Streptococcus suis meningitis.
See this image and copyright information in PMC

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