The following is a summary of “High risk and low prevalence diseases: Adult bacterial meningitis,” published in the March 2023 issue of Emergency Medicine by Pajor, et al.

Adult acute bacterial meningitis is an infrequent serious illness that can lead to high morbidity. For a study, researchers sought to examine the presentation, diagnosis, and management of acute bacterial meningitis in adults in the emergency department (ED), highlighting important aspects for emergency clinicians based on current evidence.

Meningitis is a disease that causes inflammation of the meninges and subarachnoid space, with typical symptoms including fever, nuchal rigidity, and altered mental status, although not all cases present these symptoms. At least two of the four primary symptoms of fever, nuchal rigidity, altered mental status, and headache will be present in up to 95% of patients. The most common bacterial causes of meningitis are S. pneumoniae and N. meningitidis. The diagnosis is typically made through cerebrospinal fluid testing using lumbar puncture, and head computed tomography before lumbar puncture may not be necessary for most patients. Empiric treatment involves vancomycin, ceftriaxone, and dexamethasone, while elevated intracranial pressure should be managed with established neurocritical care techniques.

Understanding the key features and challenges of acute bacterial meningitis can help emergency clinicians to identify and manage the condition effectively and efficiently.

Reference: sciencedirect.com/science/article/pii/S0735675722007859