S. pneumoniae is part of the normal upper respiratory tract flora, but, as with many natural flora, it can become pathogenic under the right conditions, like if the immune system of the host is suppressed. This is the most common cause of meningitis in elderly adults over 60.
Gram-negative bacillary meningitis is usually community-acquired and most frequently occurs in patients who are elderly or have underlying conditions, such as alcohol-induced cirrhosis, diabetes, malignancy, splenectomy, and glucocorticoid therapy. It also has a higher association with older patients who have urinary tract infections.
Listeria monocytogenes is one of the causes of meningitis in patients at the extremes of age (older adults and neonates), who often present as immunosuppressed patients. It can be spread through foods such as hot dogs, deli meats, pasteurized or unpasteurized milk, soft cheeses, raw meats, ice cream, raw fruit, vegetables, and smoked fish.
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