A 2-year-old with suspected meningitis has a history of which condition most associated with pneumococcal meningitis?

A 2-year-old with suspected meningitis has a history of which condition most associated with pneumococcal meningitis?

• A. Bladder infection
• B. Middle ear infection
• C. Fractured clavicle
• D. Septic arthritis

Answer: (B)

The most important idea is that pneumococcal meningitis in young children is commonly preceded by an ear infection. Streptococcus pneumoniae frequently causes otitis media, and bacteria from the middle ear can spread to the bloodstream and then to the meninges, leading to meningitis. A history of a middle ear infection fits this typical pathway in a 2-year-old. The other conditions listed don’t have as strong a link to pneumococcal meningitis as a prior ear infection in this age group.

The most important idea is that pneumococcal meningitis in young children is commonly preceded by an ear infection. Streptococcus pneumoniae frequently causes otitis media, and bacteria from the middle ear can spread to the bloodstream and then to the meninges, leading to meningitis. A history of a middle ear infection fits this typical pathway in a 2-year-old. The other conditions listed don’t have as strong a link to pneumococcal meningitis as a prior ear infection in this age group.