Virginia Via Research Day Book 2026

Medical Resident Research Case Reports

20 A PECULIAR PERIL IN PREGNANCY: PNEUMOCOCCAL MENINGITIS

Rashaun Spencer, MD; Eric O'Neal, MD; Kimberly Bird, MD Corresponding author: Rashaun.Spencer@LPNT.net

LewisGale Medical Center, Salem, Virginia

Due to history of an anaphylactic reaction to penicillin, amoxicillin, and metronidazole, the pharmacy was consulted, and the patient was started on IV Linezolid and Meropenem. Comments: Pneumococcal Meningitis is a subset of bacterial meningitis, a medical emergency requiring immediate treatment. Mechanism of transmission involves transmission of the pathogen through the central nervous system. The most common cause of bacterial meningitis is Streptococcus Pneumoniae. Risk factors include altered mental status, elevated ESR, and thrombocytopenia. Studies reveal 5 documented, single case report studies of pneumococcal meningitis during pregnancy, revealing either the mother passing away, the infant passing away, or both. Due to concern for the patient's and her baby's condition, they were transferred to Roanoke Carilion for further management. Repeat CSF studies revealed Pneumococcal meningitis, and the patient and her infant received appropriate IV antibiotic treatment. The patient and her infant are doing well at this time. Group B Strep Meningitis, despite being a rare condition, is an important diagnosis to recognize and

effectively treat the patient and infant. If a severe allergy is noted for guideline treatment, alternative measures and/or desensitization must be considered for appropriate coverage and duration. Diagnosis : Pneumococcal Meningitis, in the setting of a prenatal Group B Strep vaginal infection. References: [1] DiNubile, M. Meningitis Due to Pneumococcus. Clinical Infectious Diseases 1990 Jul-Aug; 12(4);e717 718. [2] Landrum, L., Hawkins, A., Goodman, J. Pneumococcal Meningitis during Pregnancy: A Case Report and Review of Literature. Infectious Diseases in Obstetrics and Gynecology 2007 Mar; 2007(1);e063624.

Context: Pneumococcal meningitis is a unique condition that is commonly seen in neonates, 0.5 cases per 1000 live births and in nonpregnant, immunocompromised adults, 11 cases per 100,000 people. Report of Case: We present a 29-year-old G2P2 female with a significant past medical history of Kawasaki Disease, Gestational Diabetes Mellitus, History of an emergency C-section, and previous history of who presented to the hospital for altered mental status. At the time of presentation, her antepartum history was vaguely known. Microbiology studies noted Group B Strep via vaginal swab at 36 weeks. Her vaginal delivery was complicated by a first degree perineal laceration. She received an epidural and a transfusion of 1unit pRBCs. However, her postpartum course was complicated by an acute, progressively worsening headache, along with nausea, confusion, and agitation. Physical examination was significant for sepsis, nuchal rigidity and a positive Brudzinski sign. Despite escalating chemical sedation, the patient required Precedex GTT for imaging. Head CT was negative. Lumbar puncture was significant for bacterial meningitis but did not reveal any identifiable organism.

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151 2026 Research Recognition Day