Bacterial Meningitis
Antibiotics and Chemotherapy Vol. 45 Series Editor H. SchOnfeld, Grenzach KAR.GER. Basel Miinchen Paris London New York. New Delhi Bangkok Singapore Tokyo Sydney
Bacterial Meningitis Volume Editors H. SchOnfeld, Grenzach H. Helwig, Freiburg i. Br. 11 figures and 49 tables, 1992 KARGER Basel Miinchen Paris London New York. New Delhi Bangkok Singapore Tokyo Sydney
Antibiotics and Chemotherapy Cover illustration from Major RH (ed): Classic Description of Disease, 3rd ed, 7th printing, Springfield, Charles C. Thomas Publishers, 1978, p. 188. Library of Congress Cataloging-in-Publication Data Bacterial meningitis I volume editors, H. SchOnfeld, H. Helwig. (Antibiotics and chemotherapy: vol. 45) Includes bibliographical references and index. (alk. paper) 1. Meningitis. I. Schonfeld, H. (Hans) II. Helwig, Helmut. III. Series: Antibiotics and chemotherapy; v. 45. [DNLM: 1. Meningitis, Bacterial. WI AN855G v.45] RM260.A55 vol. 45 [RCI24] 615.5'8 s-dc20 [616.8'2] ISBN 3-8055-5484-2 Bibliographic Indices This publication is listed in bibliographic services, including Current Contents R and Index Medicus. Drug Dosage The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 1992 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland) Printed in Switzerland on acid-free paper by Thiir AG Offsetdruck, Pratteln ISBN 3-8055-5484-2
Contents Preface................................ VII Introduction...... 1 Schlech, W. F. (Halifax, N.S.): The Epidemiology of Bacterial Meningitis............ 5 Guerra-Romero, L. ; Tureen, J. H.; Tauber, M. G. (San Francisco, Calif.): Pathogenesis of Central Nervous System Injury in Bacterial Meningitis......... 18 Liu, V. C.; Smith, A L. (Seattle, Wash.): Molecular Mechanism of Haerrwphilus in- Jluenzae Pathogenicity... 30 Neu, H. C. (New York, N. Y.): Microbiology of Bacterial Meningitis Pathogens... 52 Ringelmann, R. (Karlsruhe); Heym B. (Paris); Kniehl, E. (Karlsruhe): Role of Immunological Tests in Diagnosis of Bacterial Meningitis.............. 68 Isenberg, H. (Darmstadt): Bacterial Meningitis: Signs and Symptoms... 79 Sable, C. A; Scheid, W. M. (Charlottesville, Va.): Theoretical and Practical Considerations of Antibiotic Therapy for Bacterial Meningitis... 96 Ristuccia, A. M.; Le Frock, J. L. (Sarasota, Fla.): Cerebrospinal Fluid Penetration of Antimicrobials........................................... 118.................. Helwig, H. (Freiburg): Duration of Treatment of Bacterial Meningitis.......... 153 Steele, R. W.; Steele, A J.; Gelzine, A. L. (New Orleans, La.): Ceftriaxone and Bacterial Meningitis. A Ten Year Follow-up............... 161 Lebel, M. H. (Montreal, Que.): Dexamethasone Therapy of Bacterial Meningitis... 169 Tuomanen, E. (New York, N.Y.): Adjunctive Therapy of Experimental Meningitis: Agents Other than Steroids................................... 184................ Schaad, U. B. (Berne): Etiology and Management of Neonatal Bacterial Meningitis.. 192 La Via, W. V.; Marks, M.1. (Long Beach, Calif.): Prolonged and Secondary Fevers in Childhood Bacterial Meningitis................................. 201.............. Kabani, A.; Jadavji, T. (Calgary, Alta.): Sequelae of Acute Bacterial Meningitis in Children................................................ 209................. Liitschg, J. (BruderhoIz/Binningen): Hearing Disorders in Meningitis... 218 Lebel, M. H. (Montreal, Que.): Adverse Outcome of Bacterial Meningitis due to Delayed Sterilization of Cerebrospinal Fluid........ 226 Handrick, W.; Wasser, St. (Leipzig): Seizures during Bacterial Meningitis........... 239 Kline, M. W. (Houston, Tex.): Recurrent Bacterial Meningitis...... 254 Sepkowitz, K.; Armstrong, D. (New York, N.Y.): Bacterial Meningitis in the Immunocompromised Host..................... 262 Subject Index............................................. 270..................
Preface Until the introduction of sulfonamides and penicillins some 50-60 years ago, bacterial meningitis was in most cases a deadly disease. Since then it has become curable with a variable mortality rate as for individual pathogens (e.g. Streptococcus pneumoniae, Pseudomonas spp., Staphylococcus aureus et epidermidis) and patients (neonates, immunosuppressed patients, neurosurgical patients, skull trauma, elderly patients). Following the first in vivo diagnosis by lumbar puncture performed by Quincke in 1891 and the first identification of the pathogen by Heubner in 1896, an enormous number of clinical and later on therapeutic studies were published. Experimental studies performed during the last two decades inaugurated new therapeutic approaches to the disease and improved the outcome. Even for the specialist it has become very difficult to evaluate the great number of papers published every year. Thus the editors of this volume asked a number of well-known and respected specialists to contribute to a current state-of-the-art monography dealing with the various aspects of bacterial meningitis. We are pleased to present 20 outstanding papers from many experts and their study groups. We want to express our thanks and gratitude to all of them. This volume aims to stimulate more researchers to work on the problem of bacterial meningitis and to provide clinicians with the information needed to maximize patient care. H. SchOnfeld H. Helwig