title: [Acute care of patients with bacterial meningitis].
abstract: BACKGROUND
  Bacterial meningitis is a life-threatening emergency that is still associated with high mortality and poor outcome.
  
  
  OBJECTIVE
  The purpose of this article is to provide a review of clinical presentation, diagnostic procedure, therapy, and prognosis in bacterial meningitis. Prognostic factors which could be influenced positively are identified and a focused procedure in the emergency setting and for the treatment of complications are provided.
  
  
  METHODS
  This work is based on a literature search (PubMed, guidelines) and personal experience (standard operating procedures, SOP).
  
  
  RESULTS
  Despite improved health care, bacterial meningitis is still associated with high mortality and poor neurological outcome, which has remained largely unaltered during recent decades. Diagnosis and, more importantly, effective therapy of bacterial meningitis are often delayed, having an immediate negative influence on clinical outcome. Neurological and nonneurological complications often necessitate intensive care and may occur rapidly or in the further course of the disease.
  
  
  CONCLUSIONS
  Immediate initiation of effective therapy is crucial to positively influence mortality and neurological outcome. Antibiotics should be administered within 30 min after admission. To achieve this, a focused and well-organized procedure in the emergency setting is necessary. Because of intra- and extracranial complications, patients need to be treated on intensive care units including neurological expertise and interdisciplinary support.
authors: Abteilung für Neurologie, Universitätsklinikum Köln, Kerpener Str. 62, 50924, Köln, Deutschland. henning.stetefeld@uk-koeln.de.
authors: H R
authors: HR
authors: Stetefeld
authors: Abteilung für Neurologie, Universitätsklinikum Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
authors: C
authors: C
authors: Dohmen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D057210:Delayed Diagnosis; D061345:Early Medical Intervention; D004636:Emergency Service, Hospital; D006801:Humans; D016920:Meningitis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008585:Meningitis, Meningococcal / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008590:Meningoencephalitis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents
keywords: Complications, extracranial; Complications, intracranial; Meningococcal infections; Meningoencephalitis; Mortality