Bacterial meningitis--1982.

The etiologic agents in bacterial meningitis vary with time, geography, and patient age. Predominant pathogens are Escherichia coli, group B streptococci, Listeria monocytogenes, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae. Approximately 70 percent of all cases occur in children under the age of five. The case-fatality rate in the United States in 1978 was 13.6 percent, but it is known that underreporting of cases, and therefore of case-fatalities, occurs. Prevention by vaccine appears to be the ultimate solution, but until a vaccine is developed emphasis should be on rapid diagnosis, improved management, and proper choice of antibiotic.