Guidelines for the management of acute meningitis in children and adults in South Africa
Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Taylor & Francis
Abstract
This guideline provides a rational and cost-effective approach to patients with acute meningitis, which causes considerable morbidity and mortality, predominantly in children.There are many aetiologies, but a small number of bacteria and viruses account for the majority of cases. There should be a low threshold for suspecting acute meningitis, which is a medical emergency and antibiotics should not be delayed. Blood culture and cerebrospinal fluid (CSF) analysis are the most important diagnostic tests and should be performed whenever it is safe and practical. Contraindications to lumbar puncture are discussed and an algorithm is given regarding administering empiric antibiotics and antivirals, performing blood cultures, computer tomography brain scanning and cerebrospinal fluid analysis, depending on the clinical features and availability of resources. Administration of steroids is not recommended. Guidelines are provided for definitive therapy whenever a causative organism is identified. When no organism is identified, treatment and further investigation should be guided by laboratory results and clinical response. An approach to this process is outlined in a second algorithm. The epidemiology of resistance to common pathogens is described and advice given regarding special groups, including those with recurrent meningitis or base-of-skull fractures. Advice regarding infection control, post-exposure prophylaxis and vaccination is provided.
Description
CITATION: Boyles, T. H. et al. 2013. Guidelines for the management of acute meningitis in children and adults in South Africa. Southern African Journal of Epidemiology and Infection, 28(1):5-15, doi:10.1080/10158782.2013.11441513.
The original publication is available at https://www.tandfonline.com
The original publication is available at https://www.tandfonline.com
Keywords
Citation
Boyles, T. H. et al. 2013. Guidelines for the management of acute meningitis in children and adults in South Africa. Southern African Journal of Epidemiology and Infection, 28(1):5-15, doi:10.1080/10158782.2013.11441513.