Roos K L
Department of Neurology, Indiana University School of Medicine, Indianapolis, USA.
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.
在过去10年中，细菌性脑膜炎的流行病学发生了变化，流感嗜血杆菌引起的脑膜炎发病率下降，而对青霉素和头孢菌素耐药的肺炎链球菌引起的脑膜炎发病率上升。脑膜炎球菌性脑膜炎对大学生构成的威胁日益增加。脑膜炎的成功治疗不仅需要根除细菌病原体，还需要处理颅内压升高、中风和癫痫发作等神经并发症。本文综述了急性细菌性脑膜炎的病理生理学、病因、临床表现、鉴别诊断和治疗。文中还包括了目前关于使用地塞米松治疗这种感染、化学预防的使用以及疫苗接种指征的建议。
