Acute bacterial meningitis

Semin Neurol. 2000;20(3):293-306. doi: 10.1055/s-2000-9393.


In the past 10 years the epidemiology of bacterial meningitis has changed, with a decreased incidence of meningitis caused by Haemophilus influenzae and an increasing incidence of meningitis caused by penicillin- and cephalosporin-resistant strains of Streptococcus pneumoniae. Meningococcal meningitis has become an increasing threat to college students. Successful outcome from meningitis requires not only eradication of the bacterial pathogen but also management of the neurological complications of raised intracranial pressure, stroke, and seizure activity. In this article, the pathophysiology, etiology, clinical presentation, differential diagnosis, and management of acute bacterial meningitis are reviewed. The present recommendations for the use of dexamethasone in the treatment of this infection, the use of chemoprophylaxis, and the indications for vaccinations are included.

Publication types

  • Review

MeSH terms

  • Acute Disease / therapy
  • Anti-Bacterial Agents / administration & dosage
  • Bacterial Physiological Phenomena
  • Diagnosis, Differential
  • Humans
  • Meninges / microbiology*
  • Meninges / pathology
  • Meninges / physiopathology
  • Meningitis, Bacterial / complications
  • Meningitis, Bacterial / diagnosis*
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / microbiology*
  • Neisseria meningitidis / pathogenicity
  • Neisseria meningitidis / physiology
  • Streptococcus pneumoniae / pathogenicity
  • Streptococcus pneumoniae / physiology
  • Vaccines / therapeutic use


  • Anti-Bacterial Agents
  • Vaccines