Le Tulzo Y, Bouget J, Thomas R
Clinique des maladies infectieuses et réanimation médicale, Hôpital Pontchaillou, CHRU de Rennes.
Rev Prat. 1994 Oct 15;44(16):2165-7.
Epidemic bacterial meningitis in the adult and the elderly are essentially due to Streptococcus pneumoniae. Neisseria meningitidis and Listeria monocytogenes. Their poor prognosis is mainly due to the severity of the associated encephalitis, responsible for neurological sequelae and for mortality ranging from 20 to 30% in pneumonococcal and Listeria meningitis. Treatment associates an antibiotic having rapid antibactericidal action in the CSF, suppression of possible foci of primary infections and intensive care required by the frequency of associated visceral insufficiency. Present research is centered on: 1. the appearance and progression of pneumococcal lines resistant to penicillin; 2. the trials of modulators of the inflammatory response, notably dexamethasone; 3. the improvement of antibiotic concentrations in the CSF and the cerebral parenchyma, particularly in listeria infection.
成人和老年人的流行性细菌性脑膜炎主要由肺炎链球菌、脑膜炎奈瑟菌和单核细胞增生李斯特菌引起。其预后较差主要是由于相关脑炎的严重性，这会导致神经后遗症，肺炎球菌性和李斯特菌性脑膜炎的死亡率在20%至30%之间。治疗包括使用在脑脊液中具有快速杀菌作用的抗生素、消除可能的原发性感染病灶以及针对相关内脏功能不全的频繁发生进行重症监护。目前的研究集中在：1. 对青霉素耐药的肺炎球菌菌株的出现和进展；2. 炎症反应调节剂的试验，尤其是地塞米松；3. 提高脑脊液和脑实质中的抗生素浓度，特别是在李斯特菌感染中。
