Infection and Drug Resistance (Nov 2020)
Management of Acute Bacterial Meningitis in Children
Abstract
Zain Alamarat,1 Rodrigo Hasbun2 1Division of Infectious Diseases, Department of Pediatrics, UT Health, McGovern Medical School, Houston, TX, USA; 2Division of Infectious Diseases, Department of Internal Medicine, UT Health, McGovern Medical School, Houston, TX, USACorrespondence: Rodrigo HasbunDepartment of Internal Medicine, UT Health, McGovern Medical School, 6431 Fannin St. MSE 226, Houston, TX 77030, USATel +1 (713) 500-7140Fax +1 (713) 500-5495Email [email protected]: Acute community-acquired bacterial meningitis (ABM) in children continues to have high rates of neurological morbidity and mortality despite the overall declining rates of infection attributed to the use of vaccines and intrapartum Group B Streptococcus prophylaxis. Prompt diagnosis and early antibiotic therapy are crucial and should not be delayed to obtain cranial imaging. Differentiating bacterial from viral meningitis continues to be a clinical dilemma especially in patients with previous antibiotic exposure. Clinical models and inflammatory biomarkers can aid clinicians in their diagnostic approach. Multiplex polymerase chain reaction and metagenomic next-generation sequencing are promising tools that can help in early and accurate diagnosis. This review will present the epidemiology of ABM in children, indications of cranial imaging, role of different models and serum biomarkers in diagnosing ABM, and management including the use of adjunctive therapies and methods of prevention.Keywords: management, CNS infection, meningitis, bacterial meningitis, children
