Meningitis, Bacterial

Research output: Chapter in Book/Report/Conference proceedingChapter


Bacterial meningitis is an acute purulent infection within the subarachnoid space that is followed by an inflammatory reaction that causes coma, seizure activity, increased intracranial pressure, and stroke. It is the inflammatory reaction to the invading bacteria that causes the neurological complications. The most common causative organisms of community-acquired bacterial meningitis are Streptococcus pneumoniae, Neisseria meningitidis serogroup B, group B streptococci, and Listeria monocytogenes. Streptococcus pneumoniae is the most common cause of meningitis in adults older than 20 years of age. The classic triad of symptoms and signs of meningitis is fever, headache, and stiff neck. When this triad is accompanied by lethargy, stupor, or seizure activity, the presentation is highly suggestive of bacterial meningitis. The tempo of the illness may be either that of an acute fulminant illness that progresses rapidly in a few hours or that of a subacute infection that gets progressively worse over several days. Nausea, vomiting, and photophobia are also common complaints. A stiff neck is the pathognomonic sign of meningeal irritation. When the clinical presentation is suggestive of bacterial meningitis, blood cultures should be obtained and empirical antimicrobial therapy initiated immediately. The diagnosis of bacterial meningitis is made by examination of the spinal fluid. Antimicrobial therapy is modified when the results of cerebrospinal fluid Gram's stain, culture, and antimicrobial sensitivity tests are known.

Original languageEnglish (US)
Title of host publicationEncyclopedia of the Neurological Sciences
PublisherElsevier Inc.
Number of pages6
ISBN (Electronic)9780123851574
ISBN (Print)9780123851581
StatePublished - Jan 1 2014


  • Group B streptococci
  • Listeria monocytogenes
  • Meningitis
  • Neisseria meningitidis
  • Streptococcus pneumoniae

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Roos, K. (2014). Meningitis, Bacterial. In Encyclopedia of the Neurological Sciences (pp. 1064-1069). Elsevier Inc..