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Stroke occurs in at least 17% of patients with pneumococcal meningitis (Lancet Neurol 2006; 5:123). De Gans's initial studies of community-acquired meningitis showed that patients receiving dexamethasone with antibiotics had lower mortality and fewer systemic complications than those who received antibiotics alone (N Engl J Med 2002; 347:1549). Researchers now report the identification of delayed cerebral thrombosis in six patients with community-acquired meningitis and in five additional patients reported in the literature.
Nine of the 11 patients were men. The authors' six patients received a four-day course of dexamethasone initiated along with antibiotics and were making good or excellent recovery. These patients developed thalamic or br…