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Meningitis, Bacterial

Felix B. Chang, MD, DABMA, FAAMA Reviewed 06/2018
 


BASICS

DESCRIPTION

  • A potentially life-threatening bacterial infection of the meninges

  • System affected: nervous

EPIDEMIOLOGY

  • Predominant age: neonates, infants, and elderly

  • Predominant sex: male = female

Incidence

DIAGNOSIS

HISTORY

  • Antecedent upper respiratory infection

  • Fever, headache, vomiting, photophobia

  • Seizures, confusion, nausea, rigors

  • Profuse sweats, weakness

  • Elderly: subtle findings including confusion

  • Infa...

TREATMENT

GENERAL MEASURES

  • Initiate empiric antibiotic therapy immediately after lumbar puncture (LP > Abx), or if head CT scan is needed, then immediately after blood cultures (Abx > CT > LP)...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Brainstem auditory—evoked response hearing test for infants before hospital discharge

  • Vaccinations

    • 4 doses Hib conjugate vaccine recommended dur...

REFERENCES

1 Centers for Disease Control and Prevention. Meningitis. https://www.cdc.gov/meningitis/bacterial.html. Accessed August 20, 2017.
2 Zalmanovici Trestioreanu A, Fraser A, Gafter-Gvili A, e...

ADDITIONAL READING

  • Tunkel A, Hasbun R, Bhimraj A, et al. 2017 Infectious Diseases Society of America’s clinical practice guidelines for healthcare-associated ventriculitis and meningitis [published on...

CODES

ICD10

  • G00.9 Bacterial meningitis, unspecified

  • G00.2 Streptococcal meningitis

  • G00.8 Other bacterial meningitis

  • G00.1 Pneumococcal meningitis

  • G00.3 Staphylococcal meningitis

  • G00.0 Hemophilus meningitis

ICD9

CLINICAL PEARLS

  • Classic triad of fever, neck stiffness, and altered mental status has low sensitivity for bacterial meningitis.

  • Adjunctive dexamethasone should not be given to adults who have already r...

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