总结

• Rare but serious inflammation of the meninges caused by various bacteria. Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis are the predominant causative pathogens, in both adults and children.
• Most commonly affects extremes of age (<5 years and >60 years) because of impaired or waning immunity.
• Overall incidence of bacterial meningitis has fallen in developed countries because of the widespread use of pneumococcal and Hib vaccines. S pneumoniae is the most common cause of bacterial meningitis in the US and many countries worldwide.
• An LP to obtain CSF is the most important investigation when a diagnosis of bacterial meningitis is considered.
• Empiric antimicrobial therapy should be started promptly. When the specific organism is identified, treatment can be modified accordingly.
• Hearing should be tested before discharge or within 4 weeks after discharge in all children with bacterial meningitis to detect any hearing loss as early as possible.