Anaphylaxis is a life threatening hypersensitivity reaction that can cause shock. Epidemiology studies show anaphylaxis and anaphylactic shock is relatively rare, but its incidence is increasing. A review of the pathophysiology of anaphylaxis can provide insight into clinical decisions. Diagnosing anaphylaxis can be difficult as symptoms and history are not always obvious. Diagnostic guidelines provide an objective tool to assess for anaphylaxis. Early intervention during anaphylaxis may prevent development of shock. Management is focused on circulation support with epinephrine and IV fluids, and airway maintenance. Following an acute anaphylactic reaction, patients should be provided with a referral for follow up and educated on avoidance of triggers and use of epinephrine autoinjectors.

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Bacterial meningitis continues to be a significant source of morbidity and mortality worldwide. Streptococcus pneumoniae and Neisseria meningitidis are the most ordinary and most violent pathogens of meningitis. Clinical and experimental studies have recognized a more detailed understanding of the mechanisms resulting in brain injure, squeal and neuropsychological deficit. Vaccination has really contributed to the current turn down in the number of cases for the three most usual meningeal pathogens. Genetic targeting and/or pharmacologic blockade of the implicated pathways possibly a potential strategy for therapeutic adjunctive measures to improve outcome and may hold substantial assure, in concert with antimicrobial agents, in human with delicate bacterial meningitis