Prognosis

Morbidity

Generally, with prompt and adequate antimicrobial and supportive therapy, the outcome after acute bacterial meningitis is excellent. However, prognosis does depend on multiple factors such as age, presence of comorbidity, causative pathogen, and severity at presentation. In adults with bacterial meningitis, risk factors associated with a poor prognosis include advanced age, presence of osteitis or sinusitis, low Glasgow Coma Scale score on admission (i.e., low level of consciousness), tachycardia, absence of rash, thrombocytopenia, elevated erythrocyte sedimentation rate, low cerebrospinal fluid cell count, and positive blood culture.[17]

Up to one third of adults who have had bacterial meningitis have cognitive impairment.[114]

Mortality

The mortality rate of community-acquired bacterial meningitis is approximately 20% for all causes and up to 30% for pneumococcal meningitis. The mortality rate increases with age.[17][115]

Delayed antibiotic administration increases mortality.[25][33][96]

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