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Última revisión: 19 Jun 2025
Última actualización: 01 Nov 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • headache
  • neck stiffness
  • fever
  • altered mental status
  • confusion
  • photophobia
  • vomiting
  • seizures
  • hypothermia (infants)
  • irritability (infants)
  • lethargy (infants)
  • poor feeding (infants)
  • apnea (infants)
  • focal neurologic deficit
  • abnormal eye movement
  • facial palsy
  • balance problems/hearing impairment
  • bulging fontanel in infants

Otros factores de diagnóstico

  • high-pitched cry (infants)
  • rash
  • papilledema
  • Kernig sign
  • Brudzinski sign

Factores de riesgo

  • age ≤5 or ≥65 years
  • crowding
  • exposure to pathogens
  • nonimmunized infants
  • immunodeficiency
  • cancer
  • asplenia/hyposplenic state
  • cranial anatomic defects
  • cochlear implants
  • contiguous infection
  • smoking

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • cerebrospinal fluid (CSF) cell count and differential
  • CSF protein
  • CSF glucose
  • CSF Gram stain
  • CSF culture
  • antigen detection in CSF
  • blood culture
  • CBC and differential
  • CRP
  • electrolytes, calcium (Ca), magnesium (Mg), glucose
  • coagulation profile (prothrombin time, INR, activated PTT, fibrinogen, fibrin degradation products)
  • CT head
  • polymerase chain reaction (PCR)

Algoritmo de tratamiento

Colaboradores

Autores

Rodrigo Hasbun, MD, MPH

Professor of Medicine

UT Health Mc Govern Medical School

Houston

TX

Divulgaciones

RH has received research support and personal fees from Biomeriaux.

Omaima El Tahir, MD

PhD Candidate

Department of Pediatric infectious Diseases and Immunology, AI&II

Amsterdam UMC, Vrije Universiteit Amsterdam

Amsterdam

The Netherlands

Divulgaciones

OET declares that she has no competing interests.

Agradecimientos

Dr Rodrigo Hasbun and Omaima El Tahir would like to gratefully acknowledge Dr Marceline Tutu van Furth, previous contributor to this topic.

Divulgaciones

AMTvF declares that she has no competing interests.

Revisores por pares

Guy Thwaites, MA, MBBS, PhD, MRCP, FRCPath

Wellcome Trust Clinical Research Fellow

Centre for Molecular Microbiology and Infection

Imperial College London

London

UK

Divulgaciones

GT declares that he has no competing interests.

Wendy Ziai, MD, MPH

Assistant Professor

Neurology, Neurosurgery, and Anesthesiology and Critical Care Medicine

The Johns Hopkins University

Baltimore

MD

Divulgaciones

WZ declares that she has no competing interests.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

van de Beek D, Cabellos C, Dzupova O, et al. ESCMID guideline: diagnosis and treatment of acute bacterial meningitis. Clin Microbiol Infect. 2016 May;22(suppl 3):S37-62.Texto completo  Resumen

Tunkel AR, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America's clinical practice guidelines for healthcare-associated ventriculitis and meningitis. Clin Infect Dis. 2017 Mar;64(6):701-6.Texto completo  Resumen

Brouwer MC, McIntyre P, Prasad K, et al. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2015 Sep 12;(9):CD004405.Texto completo  Resumen

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible aquí.

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