Bacterial meningitis: Diagnosis and treatment

被引:8
作者
Russell D. Snyder
机构
[1] Department of Neurology, University of New Mexico, Albuquerque
关键词
Meningitis; Bacterial Meningitis; Lyme Disease; Invasive Pneumococcal Disease; Tuberculous Meningitis;
D O I
10.1007/s11910-003-0048-3
中图分类号
学科分类号
摘要
Bacterial meningitis, once almost universally fatal, remains a cause of serious neurologic illness and subsequent disability. The initial diagnosis, although sometimes clear-cut, can be subtle and difficult. Appropriate intervention may have a favorable influence on outcome. The advent of corticosteroids and brain imaging has improved management but created controversy concerning the sequence at which various interventions should be introduced. Empiric treatment with antibiotics is important in the initial stages. Complications can arise, such as seizures, increased intracranial pressure, and ischemia. The prognosis remains unfavorable for some affected individuals in spite of advances in antibiotic management and supportive care. Copyright © 2003 by Current Science Inc.
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页码:461 / 469
页数:8
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[1]  
Schuchat A., Robinson K., Wenger J.D., Et al., Bacterial meningitis in the United States in 1995, N. Engl. J. Med., 337, pp. 970-976, (1997)
[2]  
Kastenbauer S., Pfister H.W., Pneumococcal meningitis in adults. Spectrum of complications and prognostic factors in a series of 87 cases, Brain, 126, pp. 1015-1025, (2003)
[3]  
Simon R.P., Beckman J.S., Why pus is bad for the brain, Neurology, 58, pp. 167-168, (2002)
[4]  
Rodriguez-Nunez A., Rodriquez-Garcia J., Camina F., et al, Neuron-specific enolase, nucleotides, nucleosides, purine bases, oxypurines and uric acid concentrations in cerebrospinal fluid of children with meningitis, Brain Dev., 25, pp. 102-106, (2003)
[5]  
vanFurth A.M., Roord J.J., vanFurth R., Roles of proinflammatory and anti-inflammatory cytokines in pathophysiology of bacterial meningitis and effect of adjunctive therapy, Infect. Immunol., 64, pp. 4883-4890, (1996)
[6]  
Scheld W.M., Koedel U., Nathan B., Et al., Pathophysiology of bacterial meningitis: Mechanism(s) of neuronal injury, J. Infect. Dis., 186, (2002)
[7]  
Tunkel A.R., Scheld W.M., Corticosteroids for everyone with meningitis?, N. Engl. J. Med., 347, pp. 1613-1614, (2002)
[8]  
Hotchkiss R.S., Karl I.E., The pathophysiology and treatment of sepsis, N. Engl. J. Med., 348, pp. 138-150, (2003)
[9]  
Heyderman R.S., Klein N.J., Emergency management of meningitis, J. R. Soc. Med., 93, pp. 225-229, (2000)
[10]  
Kilpi T., Anttila M., Kallio M.J.T., Et al., Length of prediagnostic history related to the course and sequelae of childhood bacterial meningitis, Pediatr. Infect. Dis. J., 12, pp. 184-188, (1993)