🦠 643.1 · Acute Bacterial Meningitis (Beyond Neonatal Period)

Nelson Textbook of Pediatrics 22nd Edition | Bacterial meningitis in children >1 month. Etiologies: Streptococcus pneumoniae (most common post-vaccine), Neisseria meningitidis, Haemophilus influenzae type b (rare due to vaccination). Clinical: fever, headache, nuchal rigidity, Kernig/Brudzinski signs, altered mental status, seizures. Diagnosis: CSF analysis (PMN pleocytosis, low glucose, high protein). Empiric therapy: ceftriaxone + vancomycin. Dexamethasone reduces hearing loss in Hib (and possibly pneumococcal) meningitis. Prevention: vaccination, chemoprophylaxis for contacts.