, Volume 31, Issue 1, pp 3-4
Date: 17 Dec 2004

Neurological outcome after bacterial meningitis: bridging the gap from molecules to behavior

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In 1988, a landmark study was published on the use of adjunctive treatment with dexamethasone in infants and children suffering from bacterial meningitis [1]. Subsequently, based on conflicting experimental results, an intensive discussion arose about the question of whether adjunctive dexamethasone therapy can be of benefit in all patients with bacterial meningitis, regardless of their age or the causative microorganism [2]. One important reason for restraining the implementation of cortisone during bacterial meningitis most likely is the fragmentary understanding of the molecular mechanisms underlying the immune activation and, even more important, leading to secondary brain injury.

In this context the work by Irazuzta and colleagues [3] published in this issue of Intensive Care Medicine deserves special attention. By means of a demanding experimental setting their investigation links beneficial dexamethasone effects on neurobehavioral performance in a rat model of bacterial meningiti