"Clinical presentation "
"Treatment and prognosis "
"Staphylococcus aureus: post-neurosurgical procedures, penetrating head trauma or haematogenous spread secondary to infection outside the nervous system 9"
"Bacterial meningitis, also known as pyogenic meningitis, is a life-threatening CNS infectious disease affecting the meninges, with elevated mortality and disability rates. Two bacteria - Streptococcus pneumoniae and Neisseria meningitidis - account for the majority of cases in adults 4,5,10."
"The epidemiological spectrum of pyogenic meningitis has changed in the last two decades in some countries due to routine vaccination. Largely the use of the Haemophilus influenzae type b (Hib) conjugate vaccine for infants and the heptavalent protein-polysaccharide pneumococcal conjugate vaccine (PCV7) are good examples that explain the significant reduction in H. influenza and pneumococcal disease incidences. Near elimination of serogroup C meningococcal meningitis and H. influenzae meningitis has been documented in wealthy nations 3,4."
"Streptococcus pneumoniae"
"group B streptococcus (e.g. Streptococcus agalactiae)"
"Neisseria meningitidis"
"Listeria monocytogenes"
"Staphylococcus aureus: post-neurosurgical procedures, penetrating head trauma or haematogenous spread secondary to infection outside the nervous system 9"
"Dexamethasone may be given empirically as it has been shown to reduce mortality in bacterial meningitis secondary to S. pneumoniae and H. influenzae 10-13. If the causative agent is subsequently shown to be Listeria, there is mixed evidence regarding the impact of dexamethasone 11,13. If another agent is identified, then dexamethasone can be continued or ceased on a case-by-case basis, as no clear benefit or harm has been identified 13,14."
"The diagnosis is usually confirmed by lumbar puncture via culture or PCR-based techniques on the CSF 10. Additionally, the CSF white cell count, lactate, and protein are typically raised, and the CSF glucose is typically low 10."
"The adult case fatality has a straight correlation with increasing age; the overall rate is estimated at around 16% in the USA, ranging from ~9% among patients 18 to 34 years of age vs ~23% among those older than 65 years 3."
"Streptococcus pneumoniae"
"Neisseria meningitidis"
"Listeria monocytogenes"
"Staphylococcus aureus: post-neurosurgical procedures, penetrating head trauma or haematogenous spread secondary to infection outside the nervous system 9"
"H: hydrocephalus"
"A: abscess"
"T: thrombosis"
"E: extra-axial collection (e.g. empyema and/or hygroma)"
Expected headings
"Clinical presentation "
"Treatment and prognosis "
"Complications"
"There are a great number of bacteria which can cause meningitis, however, a small number are responsible for the majority of cases 3,8,9,12,13:"
"There are a great number of bacteria which can cause meningitis, however, a small number are responsible for the majority of cases 3,8,9,12,13:"
"group B streptococcus (e.g. Streptococcus agalactiae)"
"E: extra-axial collection (e.g. empyema and/or hygroma)"
"On post-contrast MRI, the most common positive findings are thin and linear leptomeningeal enhancement (only seen in 50% of patients 7). More specifically, if seen, smooth or linear enhancement is more characteristic of acute pyogenic (bacterial) and lymphocytic viral meningitis. If a more nodular thick enhancement pattern is seen, especially involving the basal cisterns, leptomeningeal carcinomatosis or granulomatous disease is more likely 7."
"fungal meningitis: usually exhibit a thicker, lumpy or nodular enhancement 1"
"The adult case fatality has a straight correlation with increasing age; the overall rate is estimated at around 16% in the USA, ranging from ~9% among patients 18 to 34 years of age vs ~23% among those older than 65 years 3."