<p>Management of Acute Bacterial Meningitis in Children</p>

Abstract

Acute community-acquired bacterial meningitis (ABM) in children continues to have high rates of neurological morbidity and mortality despite the overall declining rates of infection attributed to the use of vaccines and intrapartum Group B Streptococcus prophylaxis. Prompt diagnosis and early antibiotic therapy are crucial and should not be delayed to obtain cranial imaging. Differentiating bacterial from viral meningitis continues to be a clinical dilemma especially in patients with previous antibiotic exposure. Clinical models and inflammatory biomarkers can aid clinicians in their diagnostic approach. Multiplex polymerase chain reaction and metagenomic next-generation sequencing are promising tools that can help in early and accurate diagnosis. This review will present the epidemiology of ABM in children, indications of cranial imaging, role of different models and serum biomarkers in diagnosing ABM, and management including the use of adjunctive therapies and methods of prevention.

Laboratory-Based Cytological and Biochemical Profile of Cerebrospinal Fluid for Children With Acute Bacterial Meningitis in Bangladesh

“…In the microbiologically confirmatory analysis of bacterial meningitis, CSF white blood cells tallies of more than 21 cells/ mm 3 had an affectability of 79% and explicitness of 81%. The concentrations of CSF glucose and protein varied from 0 to 198 mg/dL (median, 20 mg/dL) and 0.4 to 19.6 g/L (median, 2.7 g/L), respectively; microbiological culture-demonstrated bacterial meningitis was not analyzed precisely by cerebrospinal fluids protein or glucose (Alamarat et al 2020;Johansson et al 2015 andPanuganti 2017).…”

Nationwide Population-Based Epidemiological Study for Outcomes of Adjunctive Steroid Therapy in Pediatric Patients with Bacterial Meningitis in Taiwan

“…The causative pathogens of bacterial meningitis in children vary widely according to age, geographic region, or the patient’s underlying medical condition [ 20 , 21 ]. Although the overall incidence dropped after the introduction of widespread pneumococcal vaccination, S. pneumoniae remains the most common cause of pediatric bacterial meningitis [ 22 , 23 ].…”

“…Although we had a large sample size to perform an overall analysis from the NHIRD of Taiwan, our study has some limitations. First, several previous studies have demonstrated that the annual incidence of bacterial meningitis in children and causative pathogens varied with age [ 20 , 21 , 22 , 25 ]. Except for H. influenzae (ICD-9-CM codes 3200), S. pneumoniae (ICD-9-CM codes 3201), and Escherichia coli (ICD-9-CM codes 320.82), not all of the causative pathogens had ICD-9-CM codes that could be recorded in the NHIRD nationwide population-based database.…”

Educational Case: Neisseria Meningitis

“…Delays in antibiotic treatment >6 hours after presentation are associated with adverse outcomes. 14 A retrospective review of 123 cases of adult acute bacterial meningitis found that the risk of death in patients was 8.4 times higher when antibiotics were delayed >6 hours after presentation, with delay in antibiotic administration for CT and LP being a common cause of delay. 15 The Infectious Disease Society of America recommends that at least blood cultures should be obtained before empiric antibiotics are administered if an LP will be delayed.…”