title: Meningitis.
abstract: Based on strong evidence, blood cultures usually recover the causative organism of bacterial meningitis in children not pretreated with antibiotics. Based on moderate evidence, pretreatment does not adversely affect the cerebrospinal fluid cell count, but it decreases the positive test result for cerebrospinal fluid culture, especially for meningococcal meningitis. Based on some research evidence as well as consensus, children with suspected bacterial meningitis and no clinical signs of brain herniation do not need neuroimaging as part of their initial clinical evaluation. Dexamethasone adjunctive therapy in children with pneumococcal meningitis is controversial. Some experts recommend neuroimaging toward the end of therapy for all neonates with bacterial meningitis. Based on some research evidence as well as consensus, home intravenous antimicrobial therapy may be an option in selected cases of pediatric bacterial meningitis.
authors.affiliation: University of Missouri, Kansas City; Division of Infectious Diseases, Children's Mercy Hospitals and Clinics, Kansas City, MO.
authors.forename: Douglas
authors.initials: D
authors.lastname: Swanson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D059906:Neuroimaging; D013129:Spinal Puncture; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D003907:Dexamethasone