Bacterial meningitis is a life-threatening illness that is prevalent worldwide. The mortality rate of untreated disease approaches 100 percent, and, even with optimal therapy, there is a high failure rate.

The epidemiology of the disease has changed over the last 20 years, primarily as a result of the introduction of conjugate vaccines against the common meningeal pathogens, such that in parts of the world where vaccination is routinely utilized, bacterial meningitis has become a disease of adults rather than of infants and children.

Bacterial causes of meningitis
Several factors can become the causes of meningitis. The most common pathogens include Streptococcus pneumoniae, Group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae and Listeria monocytogenes

Clinical signs and bacterial meningitis symptoms
The possible presence of the disorder is suggested by the bacterial meningitis symptoms of fever, altered mental status, headache, and nuchal rigidity. Despite fever being the primary symptom, there is no significant signs of inflammation, fever, headache, or even neck stiffness. Instead, the infant may be irritable, vomit, feed poorly, appear to be slow or inactive, and a bulging fontanelle or abnormal reflexes may be present. Bacterial meningitis symptoms appear immediately or within a few days. Symptoms are likely to develop within 3 to 7 days after exposure.

Advanced symptoms of bacterial meningitis can be severe. These include fever, altered consciousness, bacteremia, seizure, brain abscess, hydrocephalus, septic shock, liver abscess, multiple septic abscesses, diabetic ketoacidosis, cerebral infarction, infections endocarditis.

Diagnosis
Diagnosis includes a thorough physical examination, looking for signs and symptoms, analysis of spinal fluid, blood and urine as well as mucous testing from nose and throat.

Treatment
The widely accepted empiric antibiotic treatment for bacterial meningitis includes cephalosporin like cefotaxime sodium. If listerial meningitis cannot be ruled, ceftriaxone sodium with ampicillin is used. In patients with an apparent meningococcal disease, penicillin is the drug of choice. Current guidelines recommend supportive therapy to treat associated clinical manifestations. Corticosteroids reduce neurologic deficits in children with H influenzae meningitis, whereas their beneficial effect in adults remains to be proved. The Intracranial pressure when there is intracranial hypertension can be reduced by the use of glycerol or mannitol. The need for full fluid replacement and maintenance is rightfully emphasized.