title: Bacterial meningitis.
abstract: Bacterial meningitis is a neurologic emergency. Vaccination against common pathogens has decreased the burden of disease. Early diagnosis and rapid initiation of empiric antimicrobial and adjunctive therapy are vital. Therapy should be initiated as soon as blood cultures have been obtained, preceding any imaging studies. Clinical signs suggestive of bacterial meningitis include fever, headache, meningismus, and an altered level of consciousness but signs may be scarce in children, in the elderly, and in meningococcal disease. Host genetic factors are major determinants of susceptibility to meningococcal and pneumococcal disease. Dexamethasone therapy has been implemented as adjunctive treatment of adults with pneumococcal meningitis. Adequate and prompt treatment of bacterial meningitis is critical to outcome. In this chapter we review the epidemiology, pathophysiology, and management of bacterial meningitis.
authors.affiliation: Department of Neurology, Kennemer Gasthuis, Haarlem, The Netherlands.
authors.forename: Sebastiaan G B
authors.initials: SG
authors.lastname: Heckenberg
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Matthijs C
authors.initials: MC
authors.lastname: Brouwer
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: D.vandeBeek@amc.uva.nl.
authors.forename: Diederik
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005990:Glycerol / Q000627:therapeutic use; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D013129:Spinal Puncture / Q000379:methods
chemical_list: D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D005990:Glycerol
keywords: Bacterial meningitis; antimicrobial resistance; antimicrobial therapy; cerebrospinal fluid analysis; dexamethasone; meningococcal infections; pneumococcal infections; vaccination