Bacterial meningitis – ten years experience

Abstract

SummaryBetween January 1968 and December 1977, 635 cases of acute bacterial meningitis were admitted to hospitals in the Birmingham Area Health Authority. The epidemiology of these cases was analysed and compared with the 270 cases which were admitted to the regional infectious diseases unit at East Birmingham Hospital (E.B.H.). In children and young adults the meningococcus was the commonest causative organism while over the age of 25 pneumococcal meningitis predominated. AlthoughHaemophilus influenzaewas the second commonest infecting organism it was a rare cause of meningitis in school children and adults, only four cases presenting in these age groups in the Birmingham Area.A detailed analysis was made of the symptoms, signs, laboratory investigations and clinical course of the 270 cases treated at E.B.H.The mortality in the patients with pneumococcal meningitis was 30%. In the meningococcal group it was 3·5% and in the haemophilus groups 7·7%.An analysis of the various treatment regimes employed in the 270 E.B.H. patients supports the view that a single antibiotic is sufficient for the therapy of most forms of bacterial meningitis. Intrathecal antibiotic administration is unnecessary in pyogenic meningitis caused by meningococci, pneumococci orH. influenzae.

Community‐Acquired Bacterial Meningitis in Adults: Categorization of Causes and Timing of Death

“…This observation has clinical and bi-P p .0001 ological plausibility. Because meningitis is a rapidly progressing disease [3,4,8,9], death would be expected to occur sooner [8,[22][23][24] when it is more directly related to the communityacquired meningitis.…”

Randomized comparison of meropenem with cefotaxime for treatment of bacterial meningitis. Meropenem Meningitis Study Group

“…Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis are the three most common bacterial pathogens causing meningitis, and in the United Kingdom between 1968 and 1977 they were associated with a mortality of 30, 7.7, and 3.5%, respectively (7). Production of ␤-lactamase by H. influenzae and, more recently, changes in the penicillin-binding proteins of S. pneumoniae, associated with the failure of penicillin and of chloramphenicol treatment of pneumococcal meningitis, have led to a change in empiric therapy (10).…”

<i>Listeria monocytogenes</i> Meningitis in an Immunocompetent Adult Patient

“…It affects males twice as often as females and usually very young, elderly and immunocompromised individuals [6]. It is clinically prudent to exercise a high degree of suspicion in young children less than 3 years old and adults more than 50 years old that present with meningitis with no clear etiology.…”