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Bacterial Meningitis and Brain Abscess

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Infectious Disease in the Aging

Part of the book series: Infectious Disease ((ID))

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Abstract

More cases of bacterial meningitis now occur in older adults, and their outcomes are worse than those seen in younger patients, especially with Streptococcus pneumoniae infection.

The symptoms and signs of bacterial meningitis are not sensitive or specific, particularly in older adults, and, therefore, a lumbar puncture is a key test in diagnosis.

Early, appropriate antibiotics for bacterial meningitis in conjunction with prior administration of dexamethasone, specifically for S. pneumoniae meningitis, are currently the best approach to treatment.

Vaccination is underutilized but may offer the best means of preventing serious Streptococcus pneumoniae infections, including meningitis.

Brain abscess is a severe complication of extension of local cranial infections or hematogenously disseminated infections; its treatment requires the coordinated efforts of neurosurgeons, critical care physicians, neuroradiologists, and infectious disease specialists to aspirate the lesions and to provide appropriate antibiotic therapy.

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Notes

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    There were no external sources of financial support for this publication, and the author has no financial conflicts of interest in the preparation of this manuscript.

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Suggested Reading

  • de Gans, J., & van de Beek, D. European Dexamethasone in Adulthood Bacterial Meningitis Study investigators. Dexamethasone in adults with bacterial meningitis. New England Journal of Medicine, 347, 1549–1556.

    Google Scholar 

  • Hasbun, R., Abrahams, J., Jekel, J., et al (2001). Computed tomography of the head before lumbar puncture in adults with suspected meningitis. New England Journal of Medicine, 345, 1727–1733.

    Article  PubMed  CAS  Google Scholar 

  • Heilpern, K.L., & Lorber, B. (1996). Focal intracranial infections. Infectious Disease Clinics of North America, 10, 879–896.

    Article  PubMed  CAS  Google Scholar 

  • Mathisen, G.E., & Johnson, J.P. (1997). Brain abscess. Clinical Infectious Diseases, 25, 763–781.

    Article  PubMed  CAS  Google Scholar 

  • Tunkel, A.R., Hartman, B.J., Kaplan, S.L., et al (2004). Practice guidelines for the management of bacterial meningitis. Clinical Infectious Diseases, 39, 1267–1284.

    Article  PubMed  Google Scholar 

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  1. Department of Medical Education, St. Mary Medical Center, 1050 Linden Avenue, Long Beach, CA, 90813, USA

    Chester Choi

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    Choi, C. (2009). Bacterial Meningitis and Brain Abscess. In: Norman, D., Yoshikawa, T. (eds) Infectious Disease in the Aging. Infectious Disease. Humana Press. https://doi.org/10.1007/978-1-60327-534-7_13

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    • DOI: https://doi.org/10.1007/978-1-60327-534-7_13

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