Jun 11, 2018 bacterial meningitis is a global public health concern, with several responsible etiologic agents that vary by age group and geographical area. Neisseria meningitidis, with five serogroups that most commonly cause meningitis. Changing epidemiology of bacterial meningitis among adults. Meningitis bacteriana in the 86 th legislature, hb 3884 required dshs to create procedures for school districts to provide information relating to bacterial meningitis to students and parents. Diagnosis and treatment of bacterial meningitis archives.
To evaluate the occurrence and prognostic relevance of seizures in adults with communityacquired bacterial meningitis. May 10, 2003 the treatment of bacterial meningitis represents one of the success stories of modern medicine, particularly antibiotics. Meningococcal disease but also other bacterial infections can present with both meningitis and sepsis. Most commonly affects adults 60 years because of impaired or waning immunity. Obtain cerebrospinal fluid by performing a lumbar puncture. Bacterial infections of the cerebrospinal fluid csf usually have a positive csf gram stain, positive csf bacterial culture, and increased. Jun 05, 2012 tury, the annual incidence of bacterial meningitis ranges from approxi. Bacterial infections may be caused by haemophilus influenzae type b, neisseria meningitidis meningococcal meningitis, and streptococcus pneumoniae pneumococcal meningitis. Cerebral angiography was performed in 27 patients 31. A hospitalbased study on etiology and prognosis of. Meningitis is the inflammation of the meninges of the brain and spinal cord as a result of either bacteria, viral or fungal infection. In the preantibiotic era bacterial meningitis was almost always fatal, but the prompt use of appropriate antibiotics together with supportive care can undoubtedly reduce the morbidity and the mortality of this condition substantially. Bacterial meningitis in adults and children is often preceded by respiratory illness or a sore throat. Approximately 80 percent of all cases are acute bacterial meningitis.
We examined the epidemiology of communityacquired bacterial meningitis among adults in england and wales between 1991 and 2002. Escherichia coli meningitis, which is most common in elderly adults and newborns and may be transmitted to a baby through the birth canal. Acute bacterial meningitis in adults the hospitalist. In its acute form, the disorder is characterized by sudden fever, headache, a stiff neck, and vomiting. Nuchal rigidity occurs in 70% of bacterial meningitis in adults. Meningitis, bacterial nord national organization for rare. Rapid diagnosis and treatment of acute community acquired. Clinical features and prognostic factors in adults with. Is vaccination indicated after communityacquired pneumococcal meningitis. The disease can also occur when certain bacteria invade the meninges directly. The infectious diseases society of america idsa has. Sigurdardottir b, bjornsson om, jonsdottir ke, erlendsdottir h, gudmundsson s. Without treatment, the casefatality rate can be as high as 70 percent, and one in five survivors of bacterial meningitis may be left with permanent sequelae. Bacterial meningitis in adults epidemiology bmj best.
Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant. Bacterial meningitis is a medical emergency requiring immediate diagnosis and immediate treatment. May 15, 2005 bacterial meningitis is a neurologic emergency. Meningitis caused by bacteria is the most likely form of the disease to cause serious, longterm complications. Aseptic and bacterial meningitis american academy of family.
Clinical features and prognostic factors in adults with bacterial. Meningitis and encephalitis fact sheet national institute. This study demonstrates important changes in the epidemiology of bacterial meningitis among uk adults. You are at higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia. Does the use of prophylactic treatment of household contacts decrease carriage or secondary cases.
The bacteria are found in the mouth, throat, or nose. Dexamethasone in adults with bacterial meningitis nejm. The estimated annual incidence of bacterial meningitis is 46 per 100 000 adults and streptococcus pneumoniae pneumococcus and neisseria meningitidis meningococcus are the causative bacteria in 80% of cases. Among 3169 cases, meningococcal infection was predominant among young adults and pneumococcal meningitis among older adults. Mcgill f, heyderman rs, panagiotou s, tunkel ar, solomon t. The mean annual incidence of communityacquired adult bacterial meningitis from laboratory reports was 0610 5 table. Several types of bacteria can first cause an upper respiratory tract infection and then travel through the bloodstream to the brain.
Between 5 to 40 percent of children and 20 to 50 percent of adults with this. Bacterial meningitis 1 definition meningitis inflammation of the meninges due to bacterial infection membranes around the brain and cns not parenchymal not to be confused with encephalitis parenchymal involvement usually viral in severe bacterial meningitis there can be parenchymal pathology and evidence of. Meningitis is an acute inflammation of the protective membranes covering the brain and spinal. Treatment and prevention of communityacquired bacterial. Cerebrospinal fluid analysis american family physician. Acute bacterial meningitis ubc critical care medicine, vancouver. In adults presenting with communityacquired acute bacterial meningitis, the sen sitivity of the classic triad of fever, neck stiffness, and altered mental status is low 44 percent, but almost all such patients present with at least two of four symptoms. All clinicians who provide acute medical care require a sound understanding of the priorities of managing a patient with suspected meningitis during the first hour. The use of corticosteroids in bacterial meningitis has been debated for more than 40 years. Suspected bacterial meningitis or viral encephalitis in. Adults with certain risk factors are also susceptible.
Meningococcal disease is covered in a separate topic. Sep 17, 2018 bacterial meningitis is a serious disease that can lead to paralysis, stroke, and even death. Acute bacterial meningitis is the most common form of meningitis. Meningitis is an inflammation of the covering of the brain and spinal cord. These include obtaining blood cultures, performing lumbar puncture and initiating appropri. Bacterial meningitis is a rare but potentially fatal disease. Children between the ages of 1 month and 2 years are the most susceptible to bacterial meningitis. Changing epidemiology of bacterial meningitis among adults in. Abstract bacterial meningitis is a medical emergency. Summary the epidemiology of bacterial meningitis has changed as a result of the. The mortality rate among meningococcal and pneumococcal infections fell from 04510 5 to 03110 5 p 00001. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Threeyear multicenter surveillance of communityacquired.
Bacterial meningitis can be difficult to diagnose as the symptoms and signs are often nonspecific, especially in young children. Cerebrovascular complications of bacterial meningitis in adults. We performed a prospective study of the type, frequency, temporal profile, and prognostic role of cerebrovascular complications in 86 adults with bacterial meningitis. The infection can cause the tissues around the brain to swell. Summarywe examined the epidemiology of communityacquired bacterial meningitis among adults in england and wales between 1991 and 2002. Diagnosis, initial management, and prevention of meningitis. Someone with bacterial meningitis will become very ill. Suspected bacterial meningitis or viral encephalitis in adults clinical guideline v2. Bacterial meningitis may also be suggested by symptoms of meningism and appropriate bacteria in the blood. What complications occur during communityacquired bacterial meningitis, what ancillary. Lifethreatening inflammation of the meninges caused by various bacteria. Endocarditis in adults with bacterial meningitis circulation. An observational crosssectional study, in which patients with seizures are selected from a prospective nationwide cohort of 696 episodes of communityacquired bacterial meningitis, confirmed by culture of csf in patients aged 16 years.
The classic triad of diagnostic signs consists of neck stiffness, sudden high fever, and altered mental status. This in turn interferes with blood flow and can result in paralysis or even stroke. The aim of this study is to know the incidence and risk factors associated with development of acute communityacquired lm meningitis in adult patients and to evaluate the clinical features, management, and outcome in this prospective case series. Dec 15, 2010 among adults in developed countries, the mortality rate from bacterial meningitis is 21 percent. Cerebrovascular complications of bacterial meningitis in. Seizures in adults with bacterial meningitis neurology. Practice guidelines for the management of bacterial meningitis. In acute bacterial meningitis, an elevated protein level usually 100 to 500 mgdl indicates bloodbrain barrier injury. Cognitive outcome in adults after bacterial meningitis.
Those at greatest risk for this disease are infants between 6 and 12 months of age. Meningitis, bacterial nord national organization for. Pdf changing epidemiology of bacterial meningitis among. If dexamethasone is utilized for meningitis, then rifampin 1020. Whilst infection due to most causes decreased, the incidence of tuberculous tb meningitis doubled over the 12 years. Pubmed and embase were systematically searched for english language studies on bacterial meningitis. Dexamethasone should be administered 1020 min before antimicrobial therapy for maximal efficacy and continued for 24 days. This topic covers communityacquired bacterial meningitis i n adults. However, the use of conjugate vaccines has reduced the incidence of bacterial meningitis in. Viral meningitis is most common and the least serious. Certain people are at increased risk for bacterial meningitis.
Bacterial meningitis bacterial meningitis is diagnosed on the clinical signs and symptoms and findings on csf examination after a lumbar puncture. Clinical features alone cannot determine whether meningitis. Diagnosis and treatment of bacterial meningitis archives of. Acute bacterial meningitis i n adults fiona mcgill, robert s heyderman, stavros panagiotou, allan r tunkel, tom solomon over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a signi. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. Among patients with meningococcal meningitis, there was a trend toward improved outcomes. Who bacterial meningitis including haemophilus influenzae. In adults with bacterial meningitis, a recent major trial demonstrated that treatment with adjunctive steroids, along with antibiotics, led to significant improvement in mortality and morbidity in patients with meningitis due to s.
Bacterial meningitis is inflammation of the lining that surrounds and protects your brain and spinal cord. Without treatment, the casefatality rate can be as high as 70 percent, and one in five survivors of bacterial meningitis may be left with permanent sequelae including hearing loss, neurologic disability, or loss of a limb. Meningitis diagnostics use cases who world health organization. Epidemiology, diagnosis, and antimicrobial treatment of acute. Management of bacterial meningitis in adults the bmj. Invasive disease meningitis and septicaemia combined due to n.
Listeria monocytogenes is the third most frequent cause of bacterial meningitis. Bacterial meningitis in adults symptoms, diagnosis and. These findings may facilitate bacterial meningitis prevention and treatment. The incidence and casefatality rates for bacterial meningitis vary by region, country, pathogen, and age group. Mar 21, 2019 bacterial meningitis is contagious and caused by infection from certain bacteria. Acute bacterial meningitis neurologic disorders merck. This topic covers communityacquired bacterial meningitis in adults. Once csf analysis is performed, for patients with a positive csf gram stain result, targeted antimicrobial therapy can be initiated in adults with. Among adults in developed countries, the mortality rate from bacterial meningitis is 21 percent.
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