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
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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