acute bacterial meningitis
bacterial meningitis
Meningeal inflammation caused by bacteria which, if untreated, is often fatal, or associated with significant sequelae.Epidemiology
60% are community acquired (C), 40% nosocomial (N); predisposing factors:
• Recent neurosurgery/use of neurosurgical devices—60% N;
• Immune dysfunction—20.5% N, 7.5% C;
• CSF leak—8.6% N, 3% C;
• Head injury—8.6% N, 3.5% C;
• Acute or chronic otitis media—< 1% N, 10% C;
• Others—Sinusitis, pneumonia, endocarditis, diabetes, alcoholism.
Microbiology
Haemophilus influenzae > Streptococcus pneumoniae > Neisseria meningitidis.
Management
Antibiotics and dexamethasone.
Mortality
± 25%; highest in those > age 60, obtunded at presentation or with seizures in past 24 hours.