Meningitis

Guideline to help with the interpretation of CSF results for the purpose of diagnosing or excluding meningitis.

Guideline for performing lumbar puncture.

Guideline for the assessment and management of meningitis-encephalitis.

Flowchart of management of bacterial meningitis in children and young people, incorporating NICE Bacterial Meningitis and Meningococcal Septicaemia Guideline CG102.

Guideline discussing aseptic meningitis pathogens, clinical presentation, diagnosis, treatment, and pathogen specific therapies.

Guidance for front line nurses on the early recognition of meningitis and sepsis (what to look for).

Guideline covering recognising, diagnosing and managing bacterial meningitis and meningococcal septicaemia in babies, children and young people under 16.

Statement reviewing the current epidemiology of bacterial meningitis in children beyond the neonatal period and provide guidelines for the empirical management of suspected bacterial meningitis in Canadian children.

Provides evidence-based recommendations on the treatment of nervous system Lyme disease and post-Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed?

Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis.

Practice guidelines to provide clinicians with recommendations for the diagnosis and treatment of bacterial meningitis.

Objective: To evaluate treatment of acute bacterial meningitis with differing volumes of initial fluid administration (up to 72 hours after first presentation) and the effects on death and neurological sequelae.

Objective: To assess the effects of antibiotics for the treatment of Lyme neuroborreliosis (LNB).

Objective: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis.

Objective: To determine if a clinical prediction rule can reliably determine which children should be hospitalized and treated with intravenous antibiotics for bacterial meningitis.

Objective: To determine the efficacy of adjuvant dexamethasone therapy in paediatric bacterial meningitis.

Objective: To review the evidence regarding the utility of obtaining head CT prior to lumbar puncture in adults with suspected bacterial meningitis.

Objective: We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations.

Objective: This review discusses the clinical signs and symptoms that should lead emergency physicians to consider CNS infection, paying particular attention to the sensitivity and specificity of different clinical findings at the bedside. Subsequently, the diagnostic workup and management of patients for whom there is high clinical suspicion for CNS infection is discussed.

Objective: To evaluate treatment of acute bacterial meningitis with differing volumes of initial fluid administration (up to 72 hours after first presentation) and the effects on death and neurological sequelae.

Objective: To assess the effects of antibiotics for the treatment of Lyme neuroborreliosis (LNB).

Objective: To examine the effect of adjuvant corticosteroid therapy versus placebo on mortality, hearing loss and neurological sequelae in people of all ages with acute bacterial meningitis.

Objective: To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians.

Objective: Our aim was to systematically identify and review the quality and performance of published clinical prediction rules (CPRs) for children with suspected bacterial meningitis.

Objective: The study objective of the present work was to calculate the performance of the Bacterial Meningitis Score by performing a meta-analysis of all published validation studies.

Objective: Our study's purpose was to assess the utility of CSF lactate in differentiating bacterial meningitis from aseptic meningitis.

Objective: To seek evidence supporting accuracy of clinical features of pediatric bacterial meningitis.

Objective: To present an overview of the major clinical manifestations of HSV infections in the pediatric population.

Objective: This article addresses considerations in clinical evaluation, need for CNS imaging before LP, interpretation of cerebrospinal fluid results, standards for and effects of timely antibiotic administration, and recommendations for specific antimicrobial therapy and corticosteroids.

Objective: In this review we outline the changing epidemiology, discuss key clinical topics, and illustrate how identification of the specific viral cause is beneficial. Neonatal meningitis may be a component of perinatal infection and is not covered here.

Objective: There has been controversy regarding the risk of cerebral herniation caused by a lumbar puncture (LP) in acute bacterial meningitis (ABM). This review discusses in detail the issues involved in this controversy.

Objective: In 2006, we started a prospective cohort study to identify and characterize host genetic traits and bacterial genetic factors controlling occurrence and outcome of bacterial meningitis (MeninGene). Here, we report data from this study, focusing on complications of LP in adults with community-acquired bacterial meningitis and the role of cranial CT prior to LP.

Objective: The aim was to evaluate the effect on outcome of adherence to European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), and Swedish guidelines regarding neuroimaging before LP.

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.

Objective: Our objectives were to analyze the prevalence and microbiology of bacterial meningitis in this group and its prevalence in relation to clinical and laboratory risk factors.

Objective: The objectives of this study were to describe the outcomes following invasive meningococcal disease (IMD) in a prospective cohort of children and adults, and to identify specific risk factors for death and development of neurological and nonneurological complications.

Objective: The aim of this study was to assess the impact of an EV positive diagnosis on the clinical management of patients admitted for meningitis over the course of two observational study periods (2005 and 2008-09) in the same clinical departments.

Objective: The goal of this study was to test the performance of the Rule of 7's in a multicenter cohort of children with CSF pleocytosis.

Objective: To compare the performance of two of these CDRs for children: the Bacterial Meningitis Score (BMS) and the Meningitest.

Objective: Enteroviruses (EV) are the main etiological agents of aseptic meningitis. Diagnosis is made by detecting the genome using RTPCR. The aim of the study was to evaluate the impact of a positive diagnosis on the management of infants, children, and adults.

Objective: A clinical prediction model was developed to distinguish Lyme meningitis from other causes of aseptic meningitis. Our objective was to prospectively validate this model.

Objective: Evaluation of children with clinically suspected neuroborreliosis (NB) is difficult. With a prospective study design we wanted to characterize children with signs and symptoms indicative for NB, investigate clinical outcome and, if possible, identify factors of importance for recovery.

Objective: To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.

Objective: To create a statistical model to predict LM versus AM in children based on history, physical, and laboratory findings during the initial presentation of meningitis.

Objective: To determine whether a ratio of observed to predicted (O:P) cerebrospinal fluid (CSF) white blood cells (WBCs) after a traumatic lumbar puncture (LP) can be used to predict which patients do not have meningitis and can safely be discharged from the hospital.

Objective: We conducted a retrospective review of children with bacterial meningitis to describe the rate at which parenteral antibiotic pretreatment sterilizes CSF cultures.

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.

Objective: The objectives of this study were to characterize Lyme meningitis (LM) in the pediatric population; to compare LM with viral meningitis (VM) with respect to epidemiology, history and physical examination, and laboratory data; and to provide means of early distinction of Lyme neuroborreliosis from other forms of aseptic meningitis.

Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).