Bacterial meningitis

Bacterial meningitis represents a life-threatening inflammation of the meninges. Streptococcus pneumoniae and Neisseria meningitidis are the predominant causative pathogens in both adults and children.

It 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.

Empiric antimicrobial therapy and dexamethasone 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 audiologic 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 and Neisseria meningitidis 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.