Mount HR, et al. - This study focuses on aseptic and bacterial meningitis. Findings suggest directing empiric antibiotics toward the most likely pathogens and adjusting it by patient age and risk factors. Researchers recommend administering dexamethasone to children and adults with suspected bacterial meningitis before or at the time of initiation of antibiotics. They reinforce using vaccination against the most common pathogens that cause bacterial meningitis. Additional infections can be prevented with chemoprophylaxis of close contacts.

• Researchers identify bacterial meningitis as a medical emergency for which prompt recognition and treatment is recommended.
• Despite the introduction of vaccinations for common pathogens that have reduced the incidence of meningitis worldwide, mortality remains high.
• They identified aseptic meningitis as the most common form of meningitis with an annual incidence of 7.6 per 100,000 adults.
• Aseptic meningitis is viral mostly that requires supportive care.
• They notice self limitation of viral meningitis, in general, with a good prognosis.
• They identify no use of examination maneuvers such as Kernig sign or Brudzinski sign in differentiating bacterial from aseptic meningitis because of variable sensitivity and specificity.
• Given unreliability of clinical findings, the diagnosis relies on the examination of cerebrospinal fluid obtained from lumbar puncture.
• Delayed initiation of antibiotics seems to worsen mortality.
• They recommend starting treatment promptly in cases where transfer, imaging, or lumbar puncture may slow a definitive diagnosis.