Meningitis is an infection of the meninges, the membrane covering the brain. It is recog nized, however, that some physicians use this al ternative treatment. The inflammation is caused by a bacterial infection and can be lifethreatening. The bacterial form of meningitis can be lifethreatening and needs to be treated quickly. Escmid promotes guidelines development in the field of infectious diseases. Pathophysiology and treatment of bacterial meningitis. Whitley7 1drexel university college of medicine, philadelphia, pennsylvania. The treatment depends on the type of meningitis you or your child has. These illnesses are often severe and include infections of the lining of the brain and spinal cord meningitis and bloodstream infections bacteremia or septicemia. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations at risk to ascertain public health measures. Cdc guidelines 2012 recommend that pregnant women be screened for gbs when 3537 weeks pregnant. The advised dexamethasone regimen in children is 0. Bacterial meningitis typically is diagnosed by growing bacteria from a sample of spinal fluid.
The antibiotic of choice depends on the organism causing the infection. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced. Bacterial meningitis united states pdf ppt case reports. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. The treatment is based on early parenteral administration of antibiotics that penetrates well into the cerebrospinal fluid csf. This axial nonenhanced computed tomography scan shows mild ventriculomegaly and sulcal effacement. International and local guidelines differ with regard to initial empirical therapy of bacterial meningitis in adults.
From its recognition in 1805 to the early 20th century, bacterial meningitis was fatal. In addition to antibiotics, dexamethasone a steroid may also be given to children over six weeks of age who have acute bacterial meningitis. It is important to identify which type of bacteria is causing the meningitis because antibiotics can help prevent some types from spreading and infecting other people. Bacterial meningitis remains a serious global health problem. Bacterial meningitis may also be suggested by symptoms of meningism and. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal. There are vaccines for 3 types of bacteria that can cause meningitis. It is important to start treatment as soon as possible. In general, there are no medications to fight the germs that cause viral meningitis, so treatment is usually aimed at easing the symptoms. For bacterial meningitis, it is also important to know which.
Diagnosis and treatment of bacterial meningitis archives of. Asymptomatic bacteriuria asb is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and. Duration of symptoms and outcome in bacterial meningitis.
Those who test positive should receive antibiotics intravenously during. The pathogens take advantage of the specific features of the immune system in the cns, replicate and induce. The epidemiology of bacterial meningitis in the united states has changed tremendously in the past 20 years. The laboratory plays a crucial role in diagnosing this devastating disease. Bacterial meningitis postypcv7 declining incidence and treatment rachel h. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures. Young children are susceptible to bacterial meningitis. Treatment for bacterial meningitis usually involves intravenous iv antibiotics. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Emerging antibiotic resistance is an upcoming challenge. The mortality rate of untreated disease due to streptococcus pneumoniae and haemophilus influenzae approaches 100 percent, and even with optimal therapy, it is associated with significant morbidity and mortality. Meningitis is an inflammation of the tissue that covers the brain and spinal cord that can be caused by several different types of, as well as viruses and fungibacteria. Bacterial meningitis bacterial meningitis is an infectionmediated inflammation of the pia, arachnoid, and subarachnoid space. Nov 01, 2004 the objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis.
Introduction bacterial meningitis is a medical emergency, and immediate steps must be taken to establish the specific cause and initiate effective therapy. Bacterial meningitis is an inflammation of the meninges, in particular the arachnoid and the pia mater, associated with the invasion of bacteria into the subarachnoid space, principles known for more than 100 years flexner, 1907. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. Claims of equivalence in randomized controlled trials of the treatment of bacterial meningitis in children. Jul 16, 2019 meningitis is a clinical syndrome characterized by inflammation of the meninges. By identifying the causative organism and determining antimicrobial susceptibility, laboratorians provide clinicians with the information required to deliver appropriate treatment to their patients. Diagnosis, initial management, and prevention of meningitis. Nov 05, 2018 meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. The bacteria are found in the mouth, throat, or nose. Meningitis is an acute bacterial infection of the meninges, which may affect the brain and lead to irreversible neurological damage and auditory impairment. Antifungal medications treat fungal meningitis, and a combination of specific antibiotics can treat tuberculous meningitis. In cases of bacterial meningitis, prompt treatment is critical to avoid serious and lifethreatening complications.
Bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. Epidemiology, diagnosis, and antimicrobial treatment of. It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and prevention. Diagnosis and treatment of bacterial meningitis archives. Few diseases have been affected more by the advent of antimicrobial therapy than bacterial meningitis. Acute bacterial meningitis must be treated immediately with intravenous antibiotics and sometimes corticosteroids. The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Prevention and treatment of bacterial meningitis in resource. The 2005 guideline from the infectious diseases society of america recommended that asb should be screened. There is a vaccine and the cdc has specific recommendations for who should receive it.
Bacterial meningitis can be treated effectively with antibiotics. Pdf diagnosis and treatment of bacterial meningitis. Prevention and treatment of bacterial meningitis in. Meningitis, especially bacterial meningitis, is a potentially lifethreatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Dainippon sumitomo pharma obtains approval in japan of a. Google scholarthomas karen e, hasbun rodrigo, jekel james, quagliarello vincent j. Pathophysiology and treatment of bacterial meningitis olaf hoffman and joerg r. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Standardized treatment of bacterial meningitis in africa in epidemic. Due to the seriousness of the infection, treatment should be started as soon as possible. Bacterial meningitis is an important cause of death both in the developed and developing world. Public health officials report that appropriate antibiotic treatment for the most.
Untreated, bacterial meningitis is almost always fatal. Military personnel and recruits are generally a highrisk group for meningococcal disease, with a reported incidence of four to. Bacterial and viral meningitis are the most common forms of this condition. Epidemiology, diagnosis, and antimicrobial treatment of acute. Most children withmeningitiswho present to emergencydepartments in the current day have aseptic meningitis, but when bacterial etiology is suspected, diagnosis and therapy should be under. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal.
Once csf analysis is performed, for patients with a positive csf gram stain result, targeted antimicrobial therapy can be initiated in adults with bacterial meningitis. Meningitis in children symptoms, warning signs, treatment. Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. Table 1 shows the common causes of bacterial meningitis in different age groups and recommended treatment schedules.
They are spread from an infected person to another by. Meningitis is an infection of the membranes meninges surrounding the brain and spinal cord. Presumptive treatment of bacterial meningitis at the peripheral level in the. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations. Meningitis about bacterial meningitis infection cdc. Dec 01, 2015 bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. This drug is widely used for various types of moderate to severe infectious diseases caused by gram positive gramnegative bacteria. The 2016 uk meningitis guidelines recommend an lp be performed without prior. Summary the epidemiology of bacterial meningitis has changed as a result of the widespread use of conjugate vaccines and preventive antimicrobial treatment of pregnant women. First, the introduction of conjugate vaccines in europe resulted in the virtual. Pharmacists should ensure that local antibiotic guidelines reflect this, along with local resistance patterns, to ensure initial treatment is appropriate. The infectious diseases society of america idsa has issued new guidelines for the diagnosis and treatment of bacterial meningitis.
With treatment, mortality risk of death from bacterial meningitis depends on the age of the person and the underlying cause. The image below depicts acute bacterial meningitis. Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting. Most studies included in the metaanalysis used dexameth asone. Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. Doctors treat bacterial meningitis with a number of antibiotics. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, learning disability, or death. Bacterial meningitis requires close monitoring in the hospital. It can be treated with appropriate antibiotics that also prevents spread. Information about bacterial meningitis and other related health topics can be found at. Paediatric meningitis treatment of bacterial infection summary paediatric bacterial meningitis can be caused by a variety of different bacteria depending upon the age of the infected child. The earlier the treatment is initiated, the better your childs outcome.
Meningococcal disease what meningococcal disease is meningococcal disease is illness caused by the bacterium neisseria meningitidis, also known as meningococcal bacteria. Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. Severe viral meningitis may also be treated in hospital. Vaccines are the most effective way to protect against certain types of bacterial meningitis. May 30, 2018 pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. Pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. This includes rest, fluids, and feverreducing medicine. Practice guidelines for the management of bacterial meningitis.
Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Most cases of meningitis in the united states are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Practice guidelines for bacterial meningitis cid 2004. Meningitis is an inflammation of the membranes meninges surrounding your brain and spinal cord. The use of corticosteroids in bacterial meningitis has been debated for more than 40 years. If dexamethasone is utilized for meningitis, then rifampin 1020 mgkgday, max 600 mgday should also. Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting in a high mortality and morbidity throughout the world. Bacterial meningitis is a disease refers to any illness that is caused by the type of bacteria called neisseria meningitidis, also known as meningococcus. Dexamethasone should be administered 1020 min before antimicrobial therapy for maximal efficacy and continued for 24 days. Pdf diagnosis and treatment of bacterial meningitis researchgate.
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