ABSTRACT
There are several diagnostic difficulties in patients presenting with the possibility of acute bacterial meningitis. Critically ill patients with meningitis are usually transferred to the critical care unit (CCU) for intensive supportive care. Meningitis may be mimicked by a variety of infectious and noninfectious disorders. The mimics of meningitis are readily ruled out on the basis of the history/physical exam and, if any doubt remains, then a lumbar puncture with cerebrospinal fluid (CSF) analysis will include or exclude the diagnosis of acute bacterial meningitis. Early and appropriate empiric antimicrobial therapy of acute bacterial meningitis in the CCUmay be lifesaving. In contrast to the differential diagnostic problem of encephalitis in the CCU, acute bacterial meningitis in the CCU is not usually a diagnostic problem but is primarily a therapeutic problem.
