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8 - Meningitis and Encephalitis

from Section 2 - Infectious Disease Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Christopher Allison
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Meningitis is inflammation of the meningeal membranes of the brain and spinal cord. Encephalitis is inflammation of the brain parenchyma with or without inflammation of the meninges. Cerebral perfusion is a function of arterial pressure and intracranial pressure (i.e., cerebral perfusion pressure = mean arterial pressure – intracranial pressure). Hypoperfusion results from cerebral edema and increased intracranial pressure (ICP). Meningitis is a life-threatening condition with up to 30% mortality and high risk of long-term neurological complications.

The differential diagnosis for meningitis and encephalitis includes subarachnoid hemorrhage, cerebral venous thrombosis, metabolic/toxic encephalopathy and other infections not involving the central nervous system (CNS).

Keywords

headachealtered mental statusinfectionlumbar puncturecerebrospinal fluidantibiotics
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 70 - 76
Publisher: Cambridge University Press
Print publication year: 2023

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References

Attia, J, Hatala, R, Cook, DJ, et al. Does this adult patient have acute meningitis? JAMA 1999;282:175–181.CrossRefGoogle ScholarPubMed
McIntyre, PB, Berkey, CS, King, SM, et al. Dexamethasone as adjunctive therapy in bacterial meningitis: A meta-analysis of randomized clinical trials since 1988. JAMA 1997;278:925–931.CrossRefGoogle ScholarPubMed
Straus, SE, Thorpe, KE, Holroyd-Leduc, J, et al. How do I perform a lumbar puncture and analyze the results to diagnose bacterial meningitis? JAMA 2006;296:2012–2022.CrossRefGoogle ScholarPubMed
Tunkel, AR, Glaser, CA, Bloch, KC, et al. The management of encephalitis: Clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis 2008;47:303–327.CrossRefGoogle ScholarPubMed
Tunkel, AR, Hartman, BJ, Kaplan, SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004;39:1267–1284.CrossRefGoogle ScholarPubMed
van de Beek, D, de Gans, J, Tunkel, AR, et al. Community-acquired bacterial meningitis in adults. N Engl J Med 2006;354:44–53.CrossRefGoogle ScholarPubMed
van de Beek, D, Drake, JM, Tunkel, AR. Nosocomial bacterial meningitis. N Engl J Med 2010;362:146–154.CrossRefGoogle ScholarPubMed

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