Penicillin-Resistant Pneumococcus and Meningitis

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To the editor: Isolates of Streptococcus pneumoniae either relatively resistant (minimal inhibitory concentration, 0.1 to 1.0 µg/mL) or fully resistant to penicillin (4 to 8 µg/mL) have been identified throughout the world (1, 2). In the United States, meningitis due to such strains have been limited to a few cases in children. This report describes, we believe, the first case in an adult.

A 68-year-old woman was admitted from a nursing home because she had temperatures up to 40°C and increasing confusion of 2 days' duration. Her neck was stiff, and she did not respond to painful stimuli. A lumbar