Complications
Local inflammatory responses to bacteria, altered cerebral blood flow, and vasculitis lead to cerebral oedema. Lumbar puncture is contraindicated in patients with suspected elevated intracranial pressure (ICP).
Maintain adequate oxygenation and normocarbia. Position patients with heads elevated 30° and in a midline position, and reduce stimuli with sedation and minimal handling.
Treat seizures aggressively.
A potential complication of bacterial meningitis that can improve with time.
More subtle consequences of bacterial meningitis that may not be apparent for several years after infection.
Survivors of severe infections may have emotional, learning, and behavioural disorders that require multi-disciplinary assessment and treatment.
Treat aggressively with benzodiazepines. Patients with seizure disorders generally require long-term anticonvulsant therapy.
Present in one third of patients. Commonly associated with Haemophilus influenzae and Streptococcus pneumoniae.
Usually asymptomatic and resolves spontaneously.
Sensorineural hearing loss occurs in 25% to 35% of patients after pneumococcal meningitis and in 5% to 10% of patients after Haemophilus influenzae type b meningitis.
Uncommon but occasionally lethal disease caused by systemic complications. In most cases it is caused by transvenous catheter lines.
Consider in patients with an impaired level of consciousness, seizures, fluctuating focal signs, and stroke.
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