Community-Acquired Bacterial Meningitis in Adults

This review summarizes recent changes in the treatment of adults with community-acquired bacterial meningitis. It explains the initial assessment and management, the use of adjunctive corticosteroids, and intensive care monitoring. The authors detail the approach to complications such as transtentorial herniation, hydrocephalus, and focal seizures. This review explains the initial assessment and management, the use of adjunctive corticosteroids, and intensive care monitoring. The authors detail the approach to complications such as transtentorial herniation, hydrocephalus, and focal seizures. 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 – 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 . . .