Abstract
Meningitis and encephalitis are life-threatening central nervous system (CNS) infections or inflammatory states which most nurse practitioners (NP) and physician assistants (PA) will encounter at some point in their careers, much more so if they practice in the neurocritical care realm. These conditions are characterized by their high morbidity and mortality if the appropriate empiric therapy is not initiated in a timely manner. In this chapter we will discuss the diagnosis and management of these infectious diseases, from initial empiric therapy to tailored treatment once specific microbiology data becomes available.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aronin SI, Peduzzi P, Quagliarello VJ. Community-acquired bacterial meningitis: risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med. 1998;129(11):862–9.
Attia J, Hatala R, Cook DJ, Wong JG. Does this adult patient have acute meningitis? JAMA. 1999;282(2):175–81.
Auburtin M, Wolff M, Charpentier J, Varon E, Le Tulzo Y, Girault C, et al. Detrimental role of delayed antibiotic administration and penicillin-nonsusceptible strains in adult intensive care unit patients with pneumococcal meningitis: the PNEUMOREA prospective multicenter study. Crit Care Med. 2006;34(11):2758e65.
Brouwer MC, McIntyre P, Prasad K, van de Beek D. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev. 2015;9:CD004405.
Centers for Disease Control and Prevention. Control and prevention of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 1997;46(RR-5):1–10.
Chaudhuri A, Martinez-Martin P, Kennedy PG, Andrew Seaton R, Portegies P, Bojar M, et al. EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol. 2008;15(7):649–59. (European Federation of Neurological Societies)
Cunha BA. Central nervous system infections in the compromised host: a diagnostic approach. Infect Dis Clin N Am. 2001;15(2):567–90.
de Gans J, van de Beek D. European dexamethasone in adulthood bacterial meningitis study I. Dexamethasone in adults with bacterial meningitis. N Engl J Med. 2002;347:1549–56.
Dunbar SA, Eason RA, Musher DM, et al. Microscopic examination of broth culture of cerebrospinal fluid in diagnosis of meningitis. J Clin Microbiol. 1998;36:1617–20.
Durand ML, Calderwood SB, Weber DJ, et al. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med. 1993;328:21–8.
Gaieski DF, Nathan BR, O'Brien NF. Emergency neurologic life support: meningitis and encephalitis. Neurocrit Care. 2015;23(Suppl 2):S110–8.
Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001;345(24):1727–33.
Hussein AS, Shafran SD. Acute bacterial meningitis in adults. A 12-year review. Medicine. 2000;79(6):360–8.
Kanegaye JT, Soliemanzadeh P, Bradley JS. Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment. Pediatrics. 2001;108(5):1169–74.
Kim DK, Bridges CB, Harriman KH. Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older—United States, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(4):88–90. doi:http://dx.doi.org/10.15585/mmwr.mm6504a5.
Korinek AM, Baugnon T, Golmard JL, et al. Risk factors for adult nosocomial meningitis after craniotomy: role of antibiotic prophylaxis. Neurosurgery. 2006;59(1):126–33.
Køster-Rasmussen R, Korshin A, Meyer CN. Antibiotic treatment delay and outcome in acute bacterial meningitis. J Infect. 2008;57:449–54.
Michael B, Menezes BF, Cunniffe J, Miller A, Kneen R, Francis G, Beeching NJ, Solomon T. Effect of delayed lumbar punctures on the diagnosis of acute bacterial meningitis in adults. Emerg Med J.2010;27(6):433–8.
MorÃs G, Garcia-Monco JC. The challenge of drug-induced aseptic meningitis revisited. JAMA Intern Med. 2014;174(9):1511–2.
Proulx N, Fréchette D, Toye B, Chan J, Kravcik S. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. QJM. 2005;94:291–8.
Saag MS, Graybill RJ, Larsen RA, et al. Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. Clin Infect Dis. 2000;30(4):710–8.
Schuchat A, Robinson K, Wenger JD, et al. Bacterial meningitis in the United States in 1995. N Engl J Med. 1997;337:970–6.
Schut ES, de Gans J, van de Beek D. Community-acquired bacterial meningitis in adults. Pract Neurol. 2008;8:8–23.
Thigpen MC, Whitney CG, Messonnier NE, et al. Bacterial meningitis in the United States, 1998–2007. N Engl J Med. 2011;364(21):2016–25.
Thomas KE, Hasbun R, Jekel J, et al. The diagnostic accuracy of Kernig’s sign, Brudzinski’s sign, and nuchal rigidity in adults with suspected meningitis. Clin Infect Dis. 2002;35:46–52.
Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84.
van de Beek D, de Gans J, Spanjaard L, et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351(18):1849–59. [Erratum, N Engl J Med 2005; 352:950]
van de Beek D, de Gans J, Tunkel AR, et al. Community-acquired bacterial meningitis in adults. N Engl J Med. 2006;354(1):44–53.
van de Beek D, Drake JM, Tunkel AR. Nosocomial bacterial meningitis. N Engl J Med. 2010;362:146e154.
Ratilal BO, Costa J, Pappamikail L, Sampaio C. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures. Cochrane Database Syst Rev. 2015;(4):CD004884.
Wong GK, Poon WS, Wai S, Yu LM, Lyon D, Lam JM. Failure of regular external ventricular drain exchange to reduce cerebrospinal fluid infection: result of a randomised controlled trial. J Neurol Neurosurg Psychiatry. 2002;73:759–61.
Roos KL, Tyler KL. Meningitis, encephalitis, brain abscess, and empyema. In: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine. 19th ed. New York: McGraw Hill Education Medical; 2015.
Bohr VV. Pneumococcal meningitis. Late neurologic sequelae and features of prognostic impact. Archives of neurology (Chicago) 41. American Medical Association. 1984;1045–49.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Pongracz, B.A., Harwood, D., Nathan, B.R. (2018). Neurological Infections. In: White, J., Sheth, K. (eds) Neurocritical Care for the Advanced Practice Clinician. Springer, Cham. https://doi.org/10.1007/978-3-319-48669-7_13
Download citation
DOI: https://doi.org/10.1007/978-3-319-48669-7_13
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-48667-3
Online ISBN: 978-3-319-48669-7
eBook Packages: MedicineMedicine (R0)