Acute bacterial meningitis in adults
- PMID: 27265346
- DOI: 10.1016/S0140-6736(16)30654-7
Acute bacterial meningitis in adults
Abstract
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%. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the CNS is improving. Clinical features alone cannot determine whether meningitis is present and analysis of cerebrospinal fluid is essential for diagnosis. Newer technologies, such as multiplex PCR, and novel diagnostic platforms that incorporate proteomics and genetic sequencing, might help provide a quicker and more accurate diagnosis. Even with appropriate antimicrobial therapy, mortality is high and so attention has focused on adjunctive therapies; adjunctive corticosteroids are beneficial in certain circumstances. Any further improvements in outcome are likely to come from either modulation of the host response or novel approaches to therapy, rather than new antibiotics. Ultimately, the best hope to reduce the disease burden is with broadly protective vaccines.
Copyright © 2016 Elsevier Ltd. All rights reserved.
Comment in
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Acute bacterial meningitis in adults.Lancet. 2017 Apr 22;389(10079):1609-1610. doi: 10.1016/S0140-6736(17)31020-6. Lancet. 2017. PMID: 28443555 No abstract available.
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