Bacterial meningitis

Life-threatening inflammation of the meninges caused by various bacteria. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib) are the predominant causative pathogens, in both adults and children. The focus of this topic is on bacterial meningitis acquired in the community.

Most commonly affects extremes of age (<2 months and >60 years) because of impaired or waning immunity.

A lumbar puncture to obtain cerebrospinal fluid is the most important investigation when a diagnosis of bacterial meningitis is considered.

Empirical 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. Long-term audiological follow-up is only needed for patients with early onset hearing loss.

Bacterial meningitis is a serious inflammation of the meninges caused by various bacteria. Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib) are the predominant causative pathogens in both adults and children.

The focus of this topic is on bacterial meningitis acquired in the community; meningitis may also be associated with invasive procedures or head trauma, but management of healthcare-associated meningitis is beyond the scope of this topic.