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Previous Volume 354:44-53 January 5, 2006 Number 1 Next

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Bacterial meningitis is a medical, neurologic, and sometimes neurosurgical emergency that requires a multidisciplinary approach. Bacterial meningitis has an annual incidence of 4 to 6 cases per 100,000 adults (defined as patients older than 16 years of age), and Streptococcus pneumoniae and Neisseria meningitidis are responsible for 80 percent of all cases.^1,2 A diagnosis of bacterial meningitis is often considered, but the disease can be difficult to recognize.^{1,2,3,4,5,6,7,8} Recommendations for antimicrobial therapy are changing as a result of the emergence of antimicrobial resistance. In this review we summarize the current concepts of the initial approach to the treatment of adults . . . [Full Text of this Article]

Initial Approach

Adjunctive Dexamethasone Therapy

Intensive Care Management

Decline in Consciousness

Focal Neurologic Abnormalities

Repeated Lumbar Puncture

Outcome

Future Directions

Source Information

From the Department of Neurology, Center of Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam (D.B., J.G.); the Department of Medicine, Monmouth Medical Center, Long Branch, N.J. (A.R.T.); and the Department of Neurology, Division of Critical Care Neurology, Mayo Clinic College of Medicine, Rochester, Minn. (E.F.M.W.).

Address reprint requests to Dr. van de Beek at the Department of Neurology H2, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands, or at d.vandebeek@amc.uva.nl.

Related Letters:

Community-Acquired Bacterial Meningitis
Abrahamian F. M., Moran G. J., Talan D. A., Gupta M., Cooper R. J., Hoffman J. R., Johnston A. M., Carr B., Gay T., Read W. L., van de Beek D.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:1429-1432, Mar 30, 2006. Correspondence

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