Meningitis and encephalitis in adolescents.

The overall incidence of bacterial meningitis has decreased due to numerous factors, but substantial disease burden remains from both bacterial and nonbacterial meningitis with or without accompanying encephalitis. Recently developed or validated surrogate markers of disease--including polymerase chain reaction, inflammatory markers, and magnetic resonance imaging--enhance diagnostic utility. Current guidelines and studies have modified the use of particular antibiotics and expanded the role of adjunctive steroid therapy in selected patients. This review provides an update to the general diagnostic evaluation, epidemiology, pathophysiology, clinical assessment, antibiotic treatment, adjunctive therapy, prognosis, and prevention of meningitis and encephalitis in the adolescent population.