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Streptococcus pneumoniae is the most common cause of meningitis in patients older than 20 years, accounting for almost 50% of the cases. N.Meningitidis is the second cause, with 25% of cases. This is due to the widespread vaccination against both H.Influenze(which had a great decline, before it was one of the most common causes) and N.Meningitidis (which had a smaller decline). N.Meningitidis accounts for up to 60% of cases in children and young adults between the ages of 2 to 20 years.This information was taken from Harrisons Internal Medicine, 17th edition. I guess First Aid has to fix that issue, the other issue I saw wasn't actualized was the most common cause of adult nephrotic syndrome, which I got to know by doing the kaplan qbank, so it is important to do the online version to get the newest information.
Since the exam is most likely to ask you a cause depending on case scenario, just look for the difference that will guide you, gram positive versus gram negative, and the characteristic petechial or pupuric skin lesions that is only seen with N. Meningitidis.
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