Bacterial Meningitis Diagnosis and Management
Summary
Bacterial meningitis remains a life-threatening infection of the meninges with substantial global morbidity and mortality. Early recognition relies on clinical features such as fever, neck stiffness and altered mental state, but definitive diagnosis hinges on examination of cerebrospinal fluid (CSF). Standard laboratory analysis includes cytology, glucose and protein measurements, Gram staining and culture. More recent advances encompass biomarker assays and molecular techniques that can reduce diagnostic delays and guide targeted therapy. Management demands prompt empiric antibiotic therapy tailored to likely pathogens, adjunctive corticosteroids to mitigate inflammatory damage, and vigilant supportive care in high-dependency settings. Rapid initiation of treatment, appropriate antimicrobial selection, and monitoring for complications such as hydrocephalus or hearing loss are essential to improve outcomes and limit long-term sequelae.
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Bacterial Meningitis Diagnosis and Management publication trend
The graph below shows the total number of articles in bacterial meningitis diagnosis and management across all publications each year (not limited to Nature Index journals).
Technical terms
Cerebrospinal fluid (CSF): The clear fluid that circulates around the brain and spinal cord, analysed to diagnose central nervous system infections.
C-reactive protein (CRP): An acute-phase protein whose concentration rises in response to inflammation, used as a biomarker in CSF to distinguish bacterial from non-bacterial meningitis.
Empiric antibiotic therapy: Initial, broad-spectrum antimicrobial treatment started before specific pathogen identification to prevent disease progression.
Multiplex polymerase chain reaction (Multiplex PCR): A molecular technique that amplifies and detects genetic material from multiple pathogens in a single assay, enabling rapid identification of causative organisms.
References
- Validation and clinical implementation of cerebrospinal fluid C-reactive protein for the diagnosis of bacterial meningitis: a prospective diagnostic accuracy study. The Lancet Regional Health - Europe (2025).
- Severe community-acquired Streptococcus pneumoniae bacterial meningitis: clinical and prognostic picture from the intensive care unit. Critical Care (2023).
- Clinical Utilization of the FilmArray Meningitis/Encephalitis (ME) Multiplex Polymerase Chain Reaction (PCR) Assay. Frontiers in Neurology (2019).
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