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Meningitis, Bacterial

Felix B. Chang Cruz, MD, FAAMA, ABIHM Reviewed 06/2020
 


BASICS

DESCRIPTION

Life-threatening bacterial infection of the meninges 

EPIDEMIOLOGY

  • Predominant age: neonates, infants, and elderly

  • Predominant sex: male = female

Incidence

Varies by age and pathogen 
  • 18–3...

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
Mount HR, Boyle SD. Aseptic and bacterial meningitis: evaluation, treatment, and prevention. Am Fam Physician.  2017;96(5):314–322.
2
Brouwer MC, McIntyre P, Prasad K, et al. Corticoste...

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

  • Rapidly evolving petechial rash (purpura fulminans) is more common in meningococcal disease.

  • Do not delay empiric therapy for lumbar puncture if meningitis is suspected and lumbar punct...

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