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Meningitis, Bacterial

Felix B. Chang Cruz, MD, FAAMA, ABIHM Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Life-threatening bacterial infection of the meninges

  • System affected: nervous

EPIDEMIOLOGY

  • Predominant age: neonates, infants, and elderly

  • Predominant sex: male = female

Incidence

Varies b...

DIAGNOSIS

HISTORY

  • Antecedent upper respiratory infection

  • Fever, headache, vomiting, photophobia

  • Seizures, confusion

  • Nausea, rigors; sweats, weakness

  • Elderly: subtle findings including confusion

  • Infants: irr...

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

    • 4 doses Hib conjugate vaccine recommended durin...

REFERENCES

1
Centers for Disease Control and Prevention. Meningitis. https://www.cdc.gov/meningitis/bacterial.html. Accessed December 6, 2018. https://www.cdc.gov/meningitis/bacterial.html. Accessed De...

ADDITIONAL READING

  • McGill F, Heyderman RS, Panagiotou S, et al. Acute bacterial meningitis in adults. Lancet.  2016;388(10063):3036–3047. [View Abstract on OvidMedline]

  • Tunkel A, Hasbun R, Bhimraj...

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

  • Consider meningococcal infection in the differential diagnosis of any patient presenting with the sudden onset of febrile illness, especially when petechiae and/or meningeal signs are ...

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