Antifungal medications treat fungal meningitis, and a combination of specific antibiotics can treat tuberculous meningitis. Introduction bacterial meningitis is a medical emergency, and immediate steps must be taken to establish the specific cause and initiate effective therapy. This drug is widely used for various types of moderate to severe infectious diseases caused by gram positive gramnegative bacteria. Meningitis is an infection of the membranes meninges surrounding the brain and spinal cord.
Emerging antibiotic resistance is an upcoming challenge. Dexamethasone should be administered 1020 min before antimicrobial therapy for maximal efficacy and continued for 24 days. The treatment depends on the type of meningitis you or your child has. Pharmacists should ensure that local antibiotic guidelines reflect this, along with local resistance patterns, to ensure initial treatment is appropriate. 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. This includes rest, fluids, and feverreducing medicine. Meningitis is an infection of the meninges, the membrane covering the brain. Few diseases have been affected more by the advent of antimicrobial therapy than bacterial meningitis. Pathophysiology and treatment of bacterial meningitis. It is essential for clinicians to recognize the clinical signs and symptoms of meningitis and understand its management and prevention. Your teen will likely stay in a hospital to get antibiotics put into his veins through an iv until the. Prevention and treatment of bacterial meningitis in. In addition to antibiotics, dexamethasone a steroid may also be given to children over six weeks of age who have acute bacterial meningitis. 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.
Meningitis is an acute bacterial infection of the meninges, which may affect the brain and lead to irreversible neurological damage and auditory impairment. Most studies included in the metaanalysis used dexameth asone. Some of the most common causes of bacterial meningitis include neisseria meningitidis, streptococcus. Meningitis in children symptoms, warning signs, treatment. Pdf diagnosis and treatment of bacterial meningitis. Bacterial meningitis requires close monitoring in the hospital. In cases of bacterial meningitis, prompt treatment is critical to avoid serious and lifethreatening complications. Bacterial meningitis postypcv7 declining incidence and treatment rachel h. This axial nonenhanced computed tomography scan shows mild ventriculomegaly and sulcal effacement. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. The antibiotic of choice depends on the organism causing the infection. Bacterial meningitis can be treated effectively with antibiotics. Asymptomatic bacteriuria asb is a common finding in many populations, including healthy women and persons with underlying urologic abnormalities.
The use of corticosteroids in bacterial meningitis has been debated for more than 40 years. Meropen is a carbapenem antibiotic preparation for injectiondeveloped by dsp and launched in japan in september 1995. It is important to start treatment as soon as possible. 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. Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. Practice guidelines for the management of bacterial meningitis. If dexamethasone is utilized for meningitis, then rifampin 1020 mgkgday, max 600 mgday should also. Diagnosis, initial management, and prevention of meningitis. By identifying the causative organism and determining antimicrobial susceptibility, laboratorians provide clinicians with the information required to deliver appropriate treatment to their patients.
Due to the seriousness of the infection, treatment should be started as soon as possible. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced. Treatment for bacterial meningitis usually involves intravenous iv antibiotics. Practice guidelines for bacterial meningitis cid 2004. Severe viral meningitis may also be treated in hospital. In the past decades the epidemiology and treatment strategies for communityacquired bacterial meningitis have significantly changed. Even with appropriate treatment, morbidity and mortality can be substantial. Jul 16, 2019 meningitis is a clinical syndrome characterized by inflammation of the meninges. However, these medications can have serious side effects, so treatment may be deferred until a laboratory can confirm that the cause is fungal. Treatment for chronic meningitis is based on the underlying cause.
First, the introduction of conjugate vaccines in europe resulted in the virtual. Given the significant morbidity and mortality associated with bacterial meningitis, accurate information is necessary regarding the important etiological agents and populations. Nov 05, 2018 meningitis is a term used to describe an inflammation of the membranes that surround the brain or the spinal cord. 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. Meningococcal disease what meningococcal disease is meningococcal disease is illness caused by the bacterium neisseria meningitidis, also known as meningococcal bacteria. The epidemiology of bacterial meningitis in the united states has changed tremendously in the past 20 years. From its recognition in 1805 to the early 20th century, bacterial meningitis was fatal. First, the introduction of conjugate vaccines in europe resulted in the virtual disappearance of.
The 2005 guideline from the infectious diseases society of america recommended that asb should be screened. Table 1 shows the common causes of bacterial meningitis in different age groups and recommended treatment schedules. The objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Cdc guidelines 2012 recommend that pregnant women be screened for gbs when 3537 weeks pregnant. May 30, 2018 pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. Meningitis is an inflammation of the membranes meninges surrounding your brain and spinal cord. The advised dexamethasone regimen in children is 0. Whitley7 1drexel university college of medicine, philadelphia, pennsylvania. Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. Diagnosis and treatment of bacterial meningitis archives of. 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.
Bacterial meningitis is a severe infectious disease of the membranes lining the brain resulting. The pathogens take advantage of the specific features of the immune system in the cns, replicate and induce. 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. Military personnel and recruits are generally a highrisk group for meningococcal disease, with a reported incidence of four to. With treatment, mortality risk of death from bacterial meningitis depends on the age of the person and the underlying cause. 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. Those who test positive should receive antibiotics intravenously during. Bacterial meningitis may also be suggested by symptoms of meningism and. This helps to ensure recovery and reduce the risk of complications, such as brain swelling and seizures.
Bacterial meningitis is an important cause of death both in the developed and developing world. Meningitis, especially bacterial meningitis, is a potentially lifethreatening condition that can rapidly progress to permanent brain damage, neurologic problems, and even death. Viral meningitis, in contrast, tends to resolve spontaneously and is rarely fatal. The image below depicts acute bacterial meningitis. The bacterial form of meningitis can be lifethreatening and needs to be treated quickly. 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. Vaccines are the most effective way to protect against certain types of bacterial meningitis. Dec 01, 2015 bacterial meningitis is a severe, lifethreatening infection of the central nervous system that requires immediate medical attention. International and local guidelines differ with regard to initial empirical therapy of bacterial meningitis in adults.
There is a vaccine and the cdc has specific recommendations for who should receive it. It can be treated with appropriate antibiotics that also prevents spread. Acute bacterial meningitis must be treated immediately with intravenous antibiotics and sometimes corticosteroids. For bacterial meningitis, it is also important to know which. Bacterial meningitis is very serious because its onset is rapid and the infection is associated with a significant risk of death. Pathophysiology and treatment of bacterial meningitis olaf hoffman and joerg r. It is recog nized, however, that some physicians use this al ternative treatment. 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. Doctors treat bacterial meningitis with a number of antibiotics. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Epidemiology, diagnosis, and antimicrobial treatment of acute. Untreated, bacterial meningitis is almost always fatal.
Bacterial meningitis remains a serious global health problem. The 2016 uk meningitis guidelines recommend an lp be performed without prior. Nov 01, 2004 the objective of these practice guidelines is to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis. Bacterial meningitis is a potentially catastrophic infectious disease associated with substantial mortality and a risk of permanent disability in survivors. Duration of symptoms and outcome in bacterial meningitis. Bacterial meningitis united states pdf ppt case reports. Pdf diagnosis and treatment of bacterial meningitis researchgate. Google scholarthomas karen e, hasbun rodrigo, jekel james, quagliarello vincent j.
The laboratory plays a crucial role in diagnosing this devastating disease. The infectious diseases society of america idsa has issued new guidelines for the diagnosis and treatment of bacterial meningitis. Diagnosis and treatment of bacterial meningitis archives. Information about bacterial meningitis and other related health topics can be found at. Claims of equivalence in randomized controlled trials of the treatment of bacterial meningitis in children. The inflammation is caused by a bacterial infection and can be lifethreatening. Most cases of meningitis in the united states are caused by a viral infection, but bacterial, parasitic and fungal infections are other causes. Young children are susceptible to bacterial meningitis. Escmid promotes guidelines development in the field of infectious diseases. The bacteria are found in the mouth, throat, or nose. These illnesses are often severe and include infections of the lining of the brain and spinal cord meningitis and bloodstream infections bacteremia or septicemia. Epidemiology, diagnosis, and antimicrobial treatment of. Standardized treatment of bacterial meningitis in africa in epidemic. Public health officials report that appropriate antibiotic treatment for the most.
In general, there are no medications to fight the germs that cause viral meningitis, so treatment is usually aimed at easing the symptoms. Streptococcus pneumoniae and neisseria meningitidis are the most common and most aggressive pathogens of meningitis. They are spread from an infected person to another by. The treatment is based on early parenteral administration of antibiotics that penetrates well into the cerebrospinal fluid csf. Prevention and treatment of bacterial meningitis in resource. Bacterial meningitis is a disease refers to any illness that is caused by the type of bacteria called neisseria meningitidis, also known as meningococcus. There are vaccines for 3 types of bacteria that can cause meningitis. 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. Pneumococcal meningitis is a rare but serious and lifethreatening form of bacterial meningitis. 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. Bacterial meningitis bacterial meningitis is an infectionmediated inflammation of the pia, arachnoid, and subarachnoid space. The earlier the treatment is initiated, the better your childs outcome. Presumptive treatment of bacterial meningitis at the peripheral level in the.
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