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Meningitis, Bacterial

Felix B. Chang, ABIM , MD. , FAAMA, ABIHM Reviewed 06/2022
 


BASICS

DESCRIPTION

Bacterial infection of the meninges resulting in inflammation, pain and systemic illness 

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, sweats, weakness. Elderly: subtle findings including confusion

  • Infant...

TREATMENT

GENERAL MEASURES

Initiate empiric antibiotic therapy immediately after lumbar puncture (lumbar puncture > Abx). If head CT scan is needed, initiate antibiotic therapy immediately after blo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • Vaccinations

    • Meningococcal vaccination:

      • All ...

REFERENCES

1
Mount HR, Boyle SD. Aseptic and bacterial meningitis: evaluation, treatment, and prevention. Am Fam Physician. 2017;96(5):314–322.
2
Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guideli...

ADDITIONAL READING

SEE ALSO

  • Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. ...

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

SNOMED

  • ...

CLINICAL PEARLS

  • Monitor prophylaxis failures and antimicrobial resistance among meningococcal isolates to inform prophylaxis recommendations.

  • Empirical therapy for suspected meningococcal disease shoul...

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