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Acute Community-Acquired Bacterial Meningitis

  • Adarsh BhimrajEmail author
Chapter

Abstract

Community-acquired bacterial meningitis is a significant cause of morbidity and mortality. The most common causative organisms are Streptococcus pneumoniae and Neisseria meningitidis. The incidence of Listeria monocytogenes infection increases over age 50 years and in those with compromised cell-mediated immunity. Symptoms and signs are not sensitive or specific enough to diagnose community-acquired bacterial meningitis. A lumbar puncture for cerebrospinal fluid is needed to reach the diagnosis, to identify the organism, and to determine antimicrobial susceptibilities. Computed tomography of the head is not necessary in all patients prior to a lumbar puncture, only in immunocompromised patients and in those who have features suggestive of or who are at risk of increased intracranial pressure. Appropriate empiric antimicrobials should be started as soon as possible.

Keywords

Meningitis Acute meningitis Community-acquired bacterial meningitis Central nervous system infection Streptococcus pneumoniae Neisseria meningitidis Listeria monocytogenes Kernig’s sign Brudzinski’s sign Jolt accentuation Neck stiffness CSF pleocytosis 

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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Section of Neurologic Infectious Diseases, Department of Infectious DiseasesCleveland Clinic FoundationClevelandUSA

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