Risk of pneumococcal meningitis is seen in

Streptococcus pneumoniae causes infection only when host resistance is lowered by contributory factors such as respiratory viral infection, pulmonary congestion, stress, malnutrition, immunodeficiency and alcoholism. Splenectomy and sickle cell disease are impoant predisposing conditions. Meningitis is the most serious of pneumococcal infection. pneumococcal meningitis occurs at all ages. Untreated cases are almost invariably fatal. Even with antibiotic therapy, the case fatality rate is about 25%. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 226