ABSTRACT
Bacterial meningitis is clinically characterized by stiff neck, headache, fever, photophobia, malaise, vomiting, alteration of consciousness, seizures, confusion, irritability, and, rarely, acute psychosis. Cerebrospinal fluid (CSF) usually reveals an elevated white blood cell count of more than 1000 white blood cells/µl, consisting of more than 60% polymorphonuclear leukocytes, an elevated total protein content and a decreased CSF/serum glucose ratio. A CSF white blood cell count of less than 1000 cells/µl may be found early in the disease, in partially treated bacterial meningitis, in overwhelming bacterial meningeal infection (‘apurulent bacterial meningitis’) and in immunosuppressed and leukopenic patients.
