Pathophysiology of acute meningitis caused by Streptococcus pneumoniae and adjunctive therapy approaches Fisiopatologia da meningite ocasionada pelo Streptococcus pneumoniae e novas possibilidades terapêuticas adjuvantes

Bacterial meningitis is the most common and serious bacterial infection of the central nervous system (CNS), characterized by an acute purulent infection of the piamater, arachnoid and subarachnoid space1. Approximately 1.2 million cases are estimated to occur annually world-wide, resulting in 135,000 deaths2,3. Streptococcus pneumoniae and Neisseria meningitidis are the main etiologic agents responsible for most of the meningitis cases in Europe and in the USA with up to 61% of total cases1. In Brazil, in 2011, among all age groups according to the Sistema de Informação de Agravos de Notificação (SINAN) were confirmed 8,676 meningitis cases, from these 37% (n=3,194) were bacterial meningitis and 41% (n=3,562) were viral meningitis. Among all the bacterial meningitis cases 35% (n=1,133) were meningococcal; 43% (n=1,383) were meningitis by other bacteria and 15% (n=487) by pneumococcus4.