ABSTRACT
Bacterial meningitis is one of the most common central nervous system (CNS) infections. Despite advances in antimicrobial therapy, it continues to be a significant cause of morbidity and mortality. A population-based observational study examining the incidence and inpatient mortality for the most important causes of community and nosocomial bacterial meningitis between 1997 and 2010 in the United States was conducted by Castelblanco et al. Entry of the infectious agent into the CNS may occur in a variety of ways. The most common route is by hematogenous dissemination from a distant infectious focus seeding the meninges. Another route is by direct extension such as sinusitis, orbital cellulitis, mastoiditis, otitis media, and odontogenic source. After the virus has been inhaled, ingested, or inoculated, it enters the lymphatic system and subsequently seeds the bloodstream. Fever, neck stiffness, and altered mental status are often presented as the classic triad of symptoms for a patient presenting with acute meningitis.
