[Childhood meningitis]

Abstract

Early and reliable diagnosis, prompt and adequate treatment, and intensive monitoring are the mainstays for normal outcome of patients with meningitis. Major progress has been achieved during the last 5-10 years. The successful implementation of the active immunization against Haemophilus influenzae type b has dramatically changed the epidemiology of bacterial meningitis: total incidence has been cut in half and approximately half of the cases now occur in adults. Important new insights into the pathogenesis and the pathophysiology have been gained resulting in specific supportive and antiinflammatory measures. Emergence of antibiotic-resistance in meningitis pathogens have lead to modified antimicrobial therapies. Knowledge about factors associated with a poor prognosis is important in selecting patients for more intensive surveillance and treatment, and in identifying candidates for new preventive or therapeutic strategies.