Community-acquired acute meningitis and encephalitis: a narrative review

Beaman, Miles H.
November 2018
Medical Journal of Australia;11/19/2018, Vol. 209 Issue 10, p449
Academic Journal
journal article
Meningitis and encephalitis are medical emergencies. Patients need prompt evaluation and immediate empiric therapy to reduce the likelihood of fatal outcomes and chronic neurological sequelae. Conjugate bacterial vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. As the results of changes in patterns of bacterial drug sensitivity, ceftriaxone is now part of the recommended empiric treatment for bacterial meningitis and should be administered as early as possible. Neuroimaging delays the treatment of meningitis and is not needed in most cases. Adjunctive corticosteroid therapy is of benefit for many patients with meningitis and should be initiated in most adults before antibiotic therapy. Molecular testing can assist the specific diagnosis of encephalitis and should be based on the exposure history and geographic risk factors relevant to the patient, but non-infectious causes of encephalitis are also common. Empiric therapy for encephalitis should be directed at the most frequently identified infectious pathogen, herpes simplex virus type 1 (ie, intravenous aciclovir). Vaccines can protect against the major pathogens of childhood infections (measles, mumps, rubella, polio, varicella viruses), influenza viruses, and exotic pathogens that cause meningitis and encephalitis (rabies, Japanese encephalitis, dengue, yellow fever, tick-borne encephalitis viruses, Mycobacterium tuberculosis).


Related Articles

  • The need to be cautious. Cosgrave, Rebecca // Practice Nursing;Oct2010, Vol. 21 Issue 10, p518 

    A letter to the editor is presented in response to the article about the provision of ACWY Vax meningitis vaccines to travellers.

  • Put clinical factors before economic ones. Willcox, Adrienne // Practice Nursing;Oct2010, Vol. 21 Issue 10, p518 

    A response by Adrienne Willcox to a letter to the editor about her article on the provision of ACWY Vax meningitis vaccines to travellers is presented.

  • Meningitis B vaccine rejected.  // Community Practitioner;Sep2013, Vol. 86 Issue 9, p6 

    The article reports on the rejection of the use of Bexsero vaccine against meningitis B from Novartis International AG by the Joint Committee on Vaccination and Immunisation (JCVI) in Great Britain.

  • Four-strain jab for meningitis to launch.  // Independent Nurse;4/16/2010, p1 

    The article mentions the launch of Menveo, a multistrain quadrivalent conjugate vaccine that protects adolescents and adults against meningitis and septicaemia caused by four major strains of the responsible bacteria. It is stated to be the first of its kind to be launched in Great Britain. The...

  • MenAfriVac® now for infants.  // Bulletin of the World Health Organization;Feb2015, Vol. 93 Issue 2, p69 

    The article reports on the approval of meningitis A vaccine, MenAfriVac, for infants by World Health Organization.

  • Acute bacterial meningitis in adults. Moayedi, Yasbanoo; Gold, Wayne L. // CMAJ: Canadian Medical Association Journal;6/12/2012, Vol. 184 Issue 9, p1060 

    The article presents several tips about acute bacterial meningitis in adults who are helpful for diagnosis and treatment of diseased patients. The tips include timely antibiotic therapy as a delay by an hour can cause unfavorable outcomes, use of lumbar puncture without prior computed tomography...

  • Meningitis complicated by mycotic aneurysms. Ramos-Estebanez, Ciro; Yavagal, Dileep // Oxford Medical Case Reports;Jun2014, Vol. 2014 Issue 3, p40 

    Mycotic aneurysms complicated by vasospasm and strokes represent a rare manifestation of bacterial meningitis. We describe a healthy woman diagnosed with bacterial meningitis and mycotic aneurysms, who received both antibiotic and corticosteroid therapy. This approach fostered a significant...

  • ANALYTICAL AND CLINICAL EVALUATION OF SYSMEX UF1000I FOR AUTOMATED SCREENING OF CEREBROSPINAL FLUIDS ANALITIÄŒKA I KLINIÄŒKA EVALUACIJA UREĐAJA SYSMEX UF1000I ZA AUTOMATSKI SKRINING CEREBROSPINALNIH TEÄŒNOSTI. Buoro, Sabrina; Ottomano, Cosimo; Esposito, Sara Appassiti; Gherardi, Patrizia; Alessio, Maria Grazia; Crippa, Alberto; Raglio, Claudio FarinaAnnibale; Lippi, Giuseppe // Journal of Medical Biochemistry;2014, Vol. 33 Issue 2, p191 

    Background: We evaluated the performance of Sysmex UF- 1000i for cell counting and differential cell count, as well as for assessment of bacteria load in cerebrospinal fluid (CSF), as a potential approach for the rapid screening of meningitis or bacterial encephalitis. Methods: We analyzed 77...

  • Corticosteroid Therapy for Patients Hospitalized With Community-Acquired Pneumonia. Singh, Meenu; Jaiswal, Nishant // Annals of Internal Medicine;5/3/2016, Vol. 164 Issue 9, p636 

    A letter to the editor is presented in response to the article "Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis," by R. A. Siemieniuk and colleagues in the 2015 issue.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics