Meningitis Encephalitis And Brain Abscess

Keith E. Loring

David C. Anderson Alan J. Kozak

Epidemiology

Pathophysiology

ClinicalFeatures

Diagnosis Treatment

ViralMeningitis ViralEncePhalitis

Epidemiology

Pathophysiology

ClinicaLFeatures

Diagnosis

Treatment

Disposition

BrainAbscess

Epidemiology

Pathophysiology

ClinicalFeatures

Diagnosis

Treatment

Chapter References

In cases of bacterial meningitis, the two most critical actions in the emergency department are to suspect it and begin empirical treatment promptly. It is often impossible to distinguish with certainty meningitides due to viruses, fungi, and other organisms or those due to neoplastic, toxic, and autoimmune processes from bacterial meningitis on the basis of clinical findings and even lumbar puncture (LP) results. Although obtaining appropriate studies, particularly cultures, is enormously helpful in eventually arriving at an appropriate diagnosis, the prompt initiation of therapy must take priority over all diagnostic maneuvers when bacterial meningitis is part of the differential diagnosis. If the clinical situation and the emergency physician's practice environment permit, the diagnostic groundwork can be laid for establishing alternative diagnoses, but never at the expense of initiating timely therapy against likely bacterial pathogens.

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