Chapter 69 - Bacterial meningitis and pyogenic abscess in adults

Summary

Bacterial meningitis is infection of the nervous system confined to the meninges and subarachnoid space. Cranial suppurative disorders include intracranial abscesses and subdural empyemas and, less commonly, epidural (extradural) empyemas. Pyogenic bacterial abscesses can be single or multiple. Acute symptomatic seizures due to neurological insults increase the risk for unprovoked seizures/epilepsy, this risk being less than the risk of a second seizure following an unprovoked seizure. Initial immediate investigations include lumbar puncture in the absence of evidence of raised intracranial pressure, blood cultures, and routine blood tests including inflammatory markers, before prompt empirical therapy. The burden of epilepsy due to bacterial meningitis can be reduced by early diagnosis and effective therapy of the meningitis, and reduction in rates of bacterial meningitis and thereby associated epilepsy though vaccinations, disease surveillance, and treatment of close contacts.