[Bacterial meningitis in adults in emergency and rescue services].
The cardinal symptoms of bacterial meningitis are headache, fever, impaired consciousness and nuchal stiffness (meningism); however, the diagnosis of acute bacterial meningitis can only be confirmed or ruled out by investigation of cerebrospinal fluid. The recommended empirical antibiotic regimen for community-acquired acute bacterial meningitis in adults in Germany is a combination of ceftriaxone and ampicillin plus adjuvant dexamethasone. An important influenceable factor for treatment success of acute bacterial meningitis is a rapid induction of antibiotic therapy, which must be initiated directly after lumbar puncture. When this is delayed for any reason, e. g. because of the necessity of cerebral computed tomography imaging before lumbar puncture, antibiotics should be started even before acquisition of cerebrospinal fluid.
Zentrale Notaufnahme, Klinikum Großhadern, Ludwig Maximilians-Universität, Marchioninistr. 15, 81377, München, Deutschland. matthias.klein@med.uni-muenchen.de.
M
M
Klein
Neurologische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians-Universität, München, Deutschland.
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HW
Pfister
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004630:Emergencies; D004636:Emergency Service, Hospital; D005858:Germany; D006801:Humans; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D013129:Spinal Puncture
D000900:Anti-Bacterial Agents
Bacterial meningitis; Listeria monocytogenes; Lumbar puncture; Neisseria meningitidis; Streptococcus pneumoniae