Open AccessJournal Article
Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention
Hillary R Mount,Sean D Boyle +1 more
TLDR
Treatment should be started promptly in cases where transfer, imaging, or lumbar puncture may slow a definitive diagnosis and empirical antibiotics should be directed toward the most likely pathogens and should be adjusted by patient age and risk factors.Abstract:
The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced the incidence of meningitis worldwide. Aseptic meningitis is the most common form of meningitis with an annual incidence of 7.6 per 100,000 adults. Most cases of aseptic meningitis are viral and require supportive care. Viral meningitis is generally self-limited with a good prognosis. Examination maneuvers such as Kernig sign or Brudzinski sign may not be useful to differentiate bacterial from aseptic meningitis because of variable sensitivity and specificity. Because clinical findings are also unreliable, the diagnosis relies on the examination of cerebrospinal fluid obtained from lumbar puncture. Delayed initiation of antibiotics can worsen mortality. Treatment should be started promptly in cases where transfer, imaging, or lumbar puncture may slow a definitive diagnosis. Empiric antibiotics should be directed toward the most likely pathogens and should be adjusted by patient age and risk factors. Dexamethasone should be administered to children and adults with suspected bacterial meningitis before or at the time of initiation of antibiotics. Vaccination against the most common pathogens that cause bacterial meningitis is recommended. Chemoprophylaxis of close contacts is helpful in preventing additional infections.read more
Citations
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Journal ArticleDOI
Usefulness of the FilmArray meningitis/encephalitis (M/E) panel for the diagnosis of infectious meningitis and encephalitis in Taiwan
TL;DR: The BioFire® ME Panel performed equivalently to the traditional PCR methods for virus detection, and better than bacterial cultures, and may aid in the rapid identification of community-acquired M/E.
Journal ArticleDOI
Methods for rapid diagnosis of meningitis etiology in adults
TL;DR: This review will discuss a holistic approach to diagnosing bacterial, mycobacterial, viral and fungal meningitis using more rapid techniques such as the cryptococcal lateral flow assay (IMMY), GeneXpert MTB/Rif Ultra (Cepheid), and FilmArray multiplex-PCR (Biofire) are three examples that have drastically changed meneditis diagnostics.
Journal ArticleDOI
Management of Acute Bacterial Meningitis in Children
Zain Alamarat,Rodrigo Hasbun +1 more
TL;DR: The epidemiology of ABM in children, indications of cranial imaging, role of different models and serum biomarkers in diagnosing ABM, and management including the use of adjunctive therapies and methods of prevention are presented.
Journal ArticleDOI
Drug-induced aseptic meningitis: 329 cases from the French pharmacovigilance database analysis.
TL;DR: Drug‐induced aseptic meningitis (DIAM) is an adverse drug reaction of exclusion; only few studies have addressed this iatrogenic disease.
Journal ArticleDOI
Viruses Causing Aseptic Meningitis: A Tertiary Medical Center Experience With a Multiplex PCR Assay.
Mohammed A. Aldriweesh,Edi A. Shafaay,Saud Alwatban,Obeid M. Alkethami,Faisal N. Aljuraisi,Mohammad Bosaeed,Mohammad Bosaeed,Naif Khalaf Alharbi +7 more
TL;DR: AsepticMeningitis is common among suspected meningitis patients, but most cases remained of unknown etiology, and the most common identified viruses were enterovirus followed by HHV-6, and there is predominance in males and the pediatric age group.
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Practice Guidelines for the Management of Bacterial Meningitis
Allan R. Tunkel,Barry J. Hartman,Sheldon L. Kaplan,Bruce A. Kaufman,Karen L. Roos,W. Michael Scheld,Richard J. Whitley +6 more
TL;DR: Allan R. Tunkel, Barry J. Hartman, Sheldon L. Kaplan, Bruce A. Kaufman, Karen L. Roos, W. Michael Scheld, and Richard J. Scheld are the authors of this study, which aims to contribute to the understanding of central nervous system disorders and its role in disease.
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David N. Gilbert,Robert C. Moellering,George M. Eliopoulos,Henry F. Chambers,Michael S. Saag +4 more
TL;DR: The sanford guide to antimicrobial therapy – trusted infectious diseaseRecommendations for antimicrobial usage and best practices for using antimicrobial agents in clinical practice are provided.
Journal ArticleDOI
Bacterial Meningitis in the United States in 1995
Anne Schuchat,Katherine Robinson,Jay D. Wenger,Lee H. Harrison,Monica M. Farley,Arthur Reingold,Lewis B. Lefkowitz,Bradley A. Perkins +7 more
TL;DR: Bacterial meningitis in the United States is now a disease predominantly of adults rather than of infants and young children, largely as a result of a 94 percent reduction in the number of cases of H. influenzaeMeningitis due to vaccine-related decline.
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