Source: Elshaboury RH, Ahiskali AS, Holt JS, Rotschafer JC. Central nervous system infections. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146071082. Accessed May 1, 2017.
Most common causes: Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenza, and Listeria monocytogenes
Availability of pneumococcal and H. influenzae vaccines has resulted in decreased incidence.
Between 2003 and 2007, approximately 4100 cases of acute community-acquired bacterial meningitis, excluding epidemics, occurred annually in the United States, resulting in about 500 deaths.
Neurologic sequelae frequently seen include.
Risk for development of sequelae depends on infecting organism; highest risk associated with pneumococcal meningitis.
TABLE 1.Mean Values of Components of Normal and Abnormal Cerebrospinal Fluid ||Download (.pdf) TABLE 1. Mean Values of Components of Normal and Abnormal Cerebrospinal Fluid
|Type ||Normal ||Bacterial ||Viral ||Fungal ||Tuberculosis |
|WBC (cells/mm3) ||<5 ||1000–5000 ||5–500 ||100–400 ||25–500 |
|Differentiala ||Monocytes ||Neutrophils ||Lymphocytes ||Lymphocytes ||Variable |
|Protein (mg/dL) ||<50 (<500 mg/L) ||Elevated ||Mild elevation ||Elevated ||Elevated |
|Glucose (mg/dL) ||45–80 (2.5–4.4 mmol/L) ||Low ||Normal ||Low ||Low |
|CSF/blood glucose ratio ||50–60% ||Decreased ||Normal ||Decreased ||Decreased |