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General Medicine

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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Related Images
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<bold>Figure 67-9</bold> Purpura fulminans in a patient with meningococcemia.

 

<bold>Figure 67-9</bold> Purpura fulminans in a patient with meningococcemia.

 

petechiae and purpura in patient with meningococcemia

 

petechiae and purpura in patient with meningococcemia

 

petechiae and purpura in patient with meningococcemia

 

petechiae and purpura in patient with meningococcemia

 
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