Summary the epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. May 30, 2018 pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. Bacterial meningitis including meningococcal disease in all patients. Our management algorithm for infants and children is shown in figure 1, and that for adults is. It can be treated with appropriate antibiotics that also prevents spread. Introduction bacterial meningitis is a medical emergency, and immediate steps must be taken to establish the specific cause and initiate effective therapy. The mortality rate of untreated disease due to streptococcus pneumoniae and haemophilus influenzae approaches 100 percent, and even with optimal therapy, it is associated with significant morbidity and mortality.
Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. Diagnosis and treatment of bacterial meningitis archives. Claims of equivalence in randomized controlled trials of the treatment of bacterial meningitis in children. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations. The epidemiology, pathogenesis, clinical features, diagnosis, initial management, and use of dexamethasone for the treatment of bacterial meningitis are discussed separately. The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Standardized treatment of bacterial meningitis in africa in epidemic. Meningitis is an inflammation of the membranes meninges surrounding your brain and spinal cord. Bacterial meningitis an overview sciencedirect topics. In general, there are no medications to fight the germs that cause viral meningitis, so treatment is usually aimed at easing the symptoms. If dexamethasone is utilized for meningitis, then rifampin 1020 mgkgday, max 600 mgday should also. Empirical treatment of community acquired meningitis. Even with appropriate treatment, morbidity and mortality can be substantial.
Meningitis, especially bacterial meningitis, is a potentially lifethreatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Untreated, bacterial meningitis is almost always fatal. Due to the seriousness of the infection, treatment should be started as soon as possible. This circumstance highlights key problem areas in the management of the disease. Abstract bacterial meningitis is a medical emergency. Meningococcal disease but also other bacterial infections can present with both meningitis and sepsis. Table 1 shows the common causes of bacterial meningitis in different age groups and recommended treatment schedules. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal. The initial treatment approach to the patient with suspected acute bacterial meningitis depends on early recognition of the meningitis syndrome, rapid diagnostic evaluation, and emergent antimicrobial and adjunctive therapy. Your teen will likely stay in a hospital to get antibiotics put into his veins through an iv until the. Bacterial and viral meningitis are the most common forms of this condition.
Emerging antibiotic resistance is an upcoming challenge. Epidemiology, diagnosis, and antimicrobial treatment of. Meningococcal disease what meningococcal disease is meningococcal disease is illness caused by the bacterium neisseria meningitidis, also known as meningococcal bacteria. Pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. It is important to start treatment as soon as possible. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. With treatment, mortality risk of death from bacterial meningitis depends on the age of the person and the underlying cause. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and. In adults with bacterial meningitis, a recent major trial demonstrated that treatment with adjunctive steroids, along with antibiotics, led to significant improvement in mortality and morbidity in patients with meningitis due to s. Meningitis in children symptoms, warning signs, treatment.
Pdf diagnosis and treatment of bacterial meningitis researchgate. All clinicians who provide acute medical care require a sound understanding of the. In recent years, bacterial meningitis has radically changed to become a disease largely of adultsin particular, of older adults. Public health officials report that appropriate antibiotic treatment for the most. The inflammation is caused by a bacterial infection and can be lifethreatening. Bacterial meningitis is an inflammation of the meninges, in particular the arachnoid and the pia mater, associated with the invasion of bacteria into the subarachnoid space, principles known for more than 100 years flexner, 1907. The image below depicts acute bacterial meningitis. Bacterial meningitis is an important cause of death both in the developed and developing world. Meningitis is an acute bacterial infection of the meninges, which may affect the brain and lead to irreversible neurological damage and auditory impairment. Practice guidelines for the management of bacterial meningitis.
Bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. Bacterial meningitis is a disease refers to any illness that is caused by the type of bacteria called neisseria meningitidis, also known as meningococcus. Doctors need to diagnose and treat meningitis quickly to prevent or. Bacterial meningitis bacterial meningitis is an infectionmediated inflammation of the pia, arachnoid, and subarachnoid space. Nov 01, 2004 the objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Duration of symptoms and outcome in bacterial meningitis. Dexamethasone should be administered 1020 min before antimicrobial therapy for maximal efficacy and continued for 24 days.
Meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. Bacterial meningitis can be treated effectively with antibiotics. Acute bacterial meningitis must be treated immediately with intravenous antibiotics and sometimes corticosteroids. Jul 16, 2019 meningitis is a clinical syndrome characterized by inflammation of the meninges. The laboratory plays a crucial role in diagnosing this devastating disease. The epidemiology of bacterial meningitis in the united states has changed tremendously in the past 20 years. Bacterial meningitis typically is diagnosed by growing bacteria from a sample of spinal fluid. Meningitis is an inflammation of the tissue that covers the brain and spinal cord that can be caused by several different types of, as well as viruses and fungibacteria. Doctors treat bacterial meningitis with a number of antibiotics. It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and prevention. Acute bacterial meningitis in adults the hospitalist. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures. Meningitis is an infection of the membranes meninges surrounding the brain and spinal cord.
Bacterial meningitis postypcv7 declining incidence and treatment rachel h. Meningitis about bacterial meningitis infection cdc. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Information about bacterial meningitis and other related health topics can be found at. Pharmacists should ensure that local antibiotic guidelines reflect this, along with local resistance patterns, to ensure initial treatment is appropriate. Ceftriaxone is now more readily available for the treatment of bacterial meningitis and has proved its efficacy as a single dose in presumptive treatment of. Meningitis is a clinical syndrome characterized by inflammation of the meninges. They are spread from an infected person to another by. Clinicians need a low threshold for suspecting meningitis, to undertake appropriate investigations and provide treatment in a timely manner, to minimise the risk of poor outcome in bacterial disease, while limiting unnecessary treatment in viral meningitis. Bacterial meningitis remains a serious global health problem. Bacterial meningitis in aging adults clinical infectious. The pathogens take advantage of the specific features of the immune system in the cns, replicate and induce inflammation. Meningitis bacteriana in the 86 th legislature, hb 3884 required dshs to create procedures for school districts to provide information relating to bacterial meningitis to students and parents.
Vaccines are the most effective way to protect against certain types of bacterial meningitis. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Google scholarthomas karen e, hasbun rodrigo, jekel james, quagliarello vincent j. Severe viral meningitis may also be treated in hospital. Diagnosis and treatment of bacterial meningitis archives of. The choice of empirical antimicrobial therapy in this situation should be governed by the. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. The bacteria are found in the mouth, throat, or nose. Most cases of meningitis in the united states are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Military personnel and recruits are generally a highrisk group for meningococcal disease, with a reported incidence of four to. Paediatric meningitis treatment of bacterial infection summary paediatric bacterial meningitis can be caused by a variety of different bacteria depending upon the age of the infected child.
Most children withmeningitiswho present to emergencydepartments in the current day have aseptic meningitis, but when bacterial etiology is suspected, diagnosis and therapy should be under. Pathophysiology and treatment of bacterial meningitis. This axial nonenhanced computed tomography scan shows mild ventriculomegaly and sulcal effacement. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced. Nov 05, 2018 meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. Dec 01, 2015 bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention.
Nov 30, 2017 bacterial meningitis can happen at any age, but infants are more susceptible. Diagnosis, initial management, and prevention of meningitis. It is important to identify which type of bacteria is causing the meningitis because antibiotics can help prevent some types from spreading and infecting other people. Prevention and treatment of bacterial meningitis in resource. Prior antibiotic treatment of bacterial meningitis may have little effect on csf cell count, glucose, and protein within the first 2 to 3 days but will reduce the yield on grams stain and culture.
The treatment depends on the type of meningitis you or your child has. Bacterial meningitis may also be suggested by symptoms of meningism and appropriate bacteria in the blood. Whitley7 1drexel university college of medicine, philadelphia, pennsylvania. Oct 15, 2001 in recent years, bacterial meningitis has radically changed to become a disease largely of adultsin particular, of older adults. Young children are susceptible to bacterial meningitis.
The treatment is based on early parenteral administration of antibiotics that penetrates well into the cerebrospinal fluid csf. The bacterial form of meningitis can be lifethreatening and needs to be treated quickly. Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. This includes rest, fluids, and feverreducing medicine. Bacterial meningitis is an inflammation of the meninges, including the pia, arachnoid, and subarachnoid space, that occurs in response to infection with bacteria andor bacterial products.
Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Among patients with meningococcal meningitis, there was a trend toward improved outcomes. Meningitis is an infection of the meninges, the membrane covering the brain. The use of corticosteroids in bacterial meningitis has been debated for more than 40 years. Meningitis bacteriana in the 86 th legislature, hb 3884 required dshs to create procedures for school districts to provide information relating to. These illnesses are often severe and include infections of the lining of the brain and spinal cord meningitis and bloodstream infections bacteremia or septicemia. Bacterial meningitis united states pdf ppt case reports. Bacterial meningitis requires close monitoring in the hospital. Meningitis can be bacterial or viral, though there are also fungal forms of the disease. There are vaccines for 3 types of bacteria that can cause meningitis. Prevention and treatment of bacterial meningitis in. Practice guidelines for bacterial meningitis cid 2004. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of.
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