Emergency Department Management of Meningitis and Encephalitis

Infectious Disease Clinics of North America

Volumn 22, Issue 1, 2008, Pages 33-52

  Fitch, Michael T ^a   Abrahamian, Fredrick M ^b,c   Moran, Gregory J ^b,c,d   Talan, David A ^b,c,d  

^a WAKE FOREST SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c OLIVE VIEW UCLA MEDICAL CENTER   (United States)

^d Medical Center   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACICLOVIR; AMPICILLIN; ANTIINFECTIVE AGENT; CEFOTAXIME; CEFTRIAXONE; CHLORAMPHENICOL; CORTICOSTEROID; COTRIMOXAZOLE; DEXAMETHASONE; PLACEBO; VANCOMYCIN;

ADJUVANT THERAPY; ANAMNESIS; ANTIVIRAL THERAPY; ASEPTIC MENINGITIS; BACTERIAL MENINGITIS; BRAIN HERNIA; CENTRAL NERVOUS SYSTEM INFECTION; CEREBROSPINAL FLUID; CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; CYTOLOGY; DRUG SUBSTITUTION; EMERGENCY CARE; ENCEPHALITIS; HERPES SIMPLEX ENCEPHALITIS; HERPES SIMPLEX VIRUS; HUMAN; LABORATORY DIAGNOSIS; LUMBAR PUNCTURE; NEUROIMAGING; PATIENT CARE; PHYSICAL EXAMINATION; REVIEW; TREATMENT DURATION; VIRUS ENCEPHALITIS;

ANTI-INFECTIVE AGENTS; EMERGENCY MEDICINE; ENCEPHALITIS, VIRAL; HUMANS; MENINGITIS, BACTERIAL; PHYSICAL EXAMINATION;

EID: 39449108586     PISSN: 08915520     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.idc.2007.10.001     Document Type: Review

References (123)

1. Fitch M.T., and van de Beek D. Emergency diagnosis and treatment of adult meningitis. Lancet Infect Dis 7 3 (2007) 191-200
2. Schuchat A., Robinson K., Wenger J.D., et al. Bacterial meningitis in the United States in 1995. Active Surveillance Team. N Engl J Med 337 14 (1997) 970-976
3. Durand M.L., Calderwood S.B., Weber D.J., et al. Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328 1 (1993) 21-28
4. van de Beek D., de Gans J., Spanjaard L., et al. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351 18 (2004) 1849-1859
5. van de Beek D., de Gans J., Tunkel A.R., et al. Community-acquired bacterial meningitis in adults. N Engl J Med 354 1 (2006) 44-53
6. Weisfelt M., van de Beek D., Spanjaard L., et al. Clinical features, complications and outcome in adults with pneumococcal meningitis: a prospective case series. Lancet Neurol 5 2 (2006) 123-129
7. Proulx N., Frechette D., Toye B., et al. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. QJM 98 4 (2005) 291-298
8. Aronin S.I., Peduzzi P., and Quagliarello V.J. Community-acquired bacterial meningitis: risk stratification for adverse clinical outcome and effect of antibiotic timing. Ann Intern Med 129 11 (1998) 862-869
9. Hussein A.S., and Shafran S.D. Acute bacterial meningitis in adults. A 12-year review. Medicine (Baltimore) 79 6 (2000) 360-368
10. Miner J.R., Heegaard W., Mapes A., et al. Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. J Emerg Med 21 4 (2001) 387-392
11. Sigurdardottir B., Bjornsson O.M., Jonsdottir K.E., et al. Acute bacterial meningitis in adults. A 20-year overview. Arch Intern Med 157 4 (1997) 425-430
12. Schmutzhard E. Viral infections of the CNS with special emphasis on herpes simplex infections. J Neurol 248 6 (2001) 469-477
13. Ratzan K.R. Viral meningitis. Med Clin North Am 69 2 (1985) 399-413
14. Baringer J.R., Klassen T., and Grumm F. Experimental herpes simplex virus encephalitis. Effect of corticosteroids and pyrimidine nucleoside. Arch Neurol 33 6 (1976) 442-446
15. Eisenstein L.E., Calio A.J., and Cunha B.A. Herpes simplex (HSV-1) aseptic meningitis. Heart Lung 33 3 (2004) 196-197
16. Selbst S.M., Friedman M.J., and Singh S.B. Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care 21 3 (2005) 165-169
17. Attia J., Hatala R., Cook D.J., et al. The rational clinical examination. Does this adult patient have acute meningitis?. JAMA 282 2 (1999) 175-181
18. Green S.M., Rothrock S.G., Clem K.J., et al. Can seizures be the sole manifestation of meningitis in febrile children?. Pediatrics 92 4 (1993) 527-534
19. Valmari P., Peltola H., Ruuskanen O., et al. Childhood bacterial meningitis: initial symptoms and signs related to age, and reasons for consulting a physician. Eur J Pediatr 146 5 (1987) 515-518
20. Michos A.G., Syriopoulou V.P., Hadjichristodoulou C., et al. Aseptic meningitis in children: analysis of 506 cases. PLoS ONE 2 (2007) e674
21. Oostenbrink R., Moons K.G., Theunissen C.C., et al. Signs of meningeal irritation at the emergency department: how often bacterial meningitis?. Pediatr Emerg Care 17 3 (2001) 161-164
22. Thomas K.E., Hasbun R., Jekel J., et al. The diagnostic accuracy of Kernig's sign, Brudzinski's sign, and nuchal rigidity in adults with suspected meningitis. Clin Infect Dis 35 1 (2002) 46-52
23. Uchihara T., and Tsukagoshi H. Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis. Headache 31 3 (1991) 167-171
24. Tyler K.L. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's. Herpes 11 Suppl 2 (2004) 57A-64A
25. Rennick G., Shann F., and de Campo J. Cerebral herniation during bacterial meningitis in children. BMJ 306 6883 (1993) 953-955
26. Shetty A.K., Desselle B.C., Craver R.D., et al. Fatal cerebral herniation after lumbar puncture in a patient with a normal computed tomography scan. Pediatrics 103 6 Pt 1 (1999) 1284-1287
27. Horwitz S.J., Boxerbaum B., and O'Bell J. Cerebral herniation in bacterial meningitis in childhood. Ann Neurol 7 6 (1980) 524-528
28. Oliver W.J., Shope T.C., and Kuhns L.R. Fatal lumbar puncture: fact versus fiction-an approach to a clinical dilemma. Pediatrics 112 3 Pt 1 (2003) e174-e176
29. Masson C.B. The dangers of diagnostic lumbar puncture in increased intracranial pressure due to brain tumor, with a review of 200 cases in which lumbar puncture was done. Research Nerv Ment Dis Proc 8 (1927) 422-434
30. Schaller W.F. Propriety of lumbar puncture in intracranial hypertension. J Neurol Psychopathol 14 (1933) 116-123
31. Sencer W. The lumbar puncture in the presence of papilledema. J Mt Sinai Hosp N Y 23 6 (1956) 808-815
32. Korein J., Cravioto H., and Leicach M. Reevaluation of lumbar puncture; a study of 129 patients with papilledema or intracranial hypertension. Neurology 9 4 (1959) 290-297
33. Archer B.D. Computed tomography before lumbar puncture in acute meningitis: a review of the risks and benefits. CMAJ 148 6 (1993) 961-965
34. Hasbun R., Abrahams J., Jekel J., et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 345 24 (2001) 1727-1733
35. Carpenter J., Stapleton S., and Holliman R. Retrospective analysis of 49 cases of brain abscess and review of the literature. Eur J Clin Microbiol Infect Dis 26 1 (2007) 1-11
36. Thompson K.A., Blessing W.W., and Wesselingh S.L. Herpes simplex replication and dissemination is not increased by corticosteroid treatment in a rat model of focal Herpes encephalitis. J Neurovirol 6 1 (2000) 25-32
37. Cinque P., Cleator G.M., Weber T., et al. The role of laboratory investigation in the diagnosis and management of patients with suspected herpes simplex encephalitis: a consensus report. The EU Concerted Action on Virus Meningitis and Encephalitis. J Neurol Neurosurg Psychiatr 61 4 (1996) 339-345
38. Carrol E.D., Beadsworth M.B., Jenkins N., et al. Clinical and diagnostic findings of an echovirus meningitis outbreak in the north west of England. Postgrad Med J 82 963 (2006) 60-64
39. Bernit E., de Lamballerie X., Zandotti C., et al. Prospective investigation of a large outbreak of meningitis due to echovirus 30 during summer 2000 in Marseilles, France. Medicine (Baltimore) 83 4 (2004) 245-253
40. Talan D.A., Hoffman J.R., Yoshikawa T.T., et al. Role of empiric parenteral antibiotics prior to lumbar puncture in suspected bacterial meningitis: state of the art. Rev Infect Dis 10 2 (1988) 365-376
41. Zunt J.R., and Marra C.M. Cerebrospinal fluid testing for the diagnosis of central nervous system infection. Neurol Clin 17 4 (1999) 675-689
42. Kanegaye J.T., Soliemanzadeh P., and Bradley J.S. Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment. Pediatrics 108 5 (2001) 1169-1174
43. Pizon A.F., Bonner M.R., Wang H.E., et al. Ten years of clinical experience with adult meningitis at an urban academic medical center. J Emerg Med 30 4 (2006) 367-370
44. Negrini B., Kelleher K.J., and Wald E.R. Cerebrospinal fluid findings in aseptic versus bacterial meningitis. Pediatrics 105 2 (2000) 316-319
45. Oostenbrink R., Moons K.G., Twijnstra M.J., et al. Children with meningeal signs: predicting who needs empiric antibiotic treatment. Arch Pediatr Adolesc Med 156 12 (2002) 1189-1194
46. Nigrovic L.E., Kuppermann N., and Malley R. Development and validation of a multivariable predictive model to distinguish bacterial from aseptic meningitis in children in the post-Haemophilus influenzae era. Pediatrics 110 4 (2002) 712-719
47. Freedman S.B., Marrocco A., Pirie J., et al. Predictors of bacterial meningitis in the era after Haemophilus influenzae. Arch Pediatr Adolesc Med 155 12 (2001) 1301-1306
48. Graham A.K., and Murdoch D.R. Association between cerebrospinal fluid pleocytosis and enteroviral meningitis. J Clin Microbiol 43 3 (2005) 1491
49. Nigrovic L.E., Kuppermann N., Macias C.G., et al. Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis. JAMA 297 1 (2007) 52-60
50. Leblebicioglu H., Esen S., Bedir A., et al. The validity of Spanos' and Hoen's models for differential diagnosis of meningitis. Eur J Clin Microbiol Infect Dis 15 3 (1996) 252-254
51. Spanos A., Harrell Jr. F.E., and Durack D.T. Differential diagnosis of acute meningitis. An analysis of the predictive value of initial observations. JAMA 262 19 (1989) 2700-2707
52. McKinney W.P., Heudebert G.R., Harper S.A., et al. Validation of a clinical prediction rule for the differential diagnosis of acute meningitis. J Gen Intern Med 9 1 (1994) 8-12
53. Hoen B., Viel J.F., Paquot C., et al. Multivariate approach to differential diagnosis of acute meningitis. Eur J Clin Microbiol Infect Dis 14 4 (1995) 267-274
54. Baty V., Viel J.F., Schuhmacher H., et al. Prospective validation of a diagnosis model as an aid to therapeutic decision-making in acute meningitis. Eur J Clin Microbiol Infect Dis 19 6 (2000) 422-426
55. Jaeger F., Leroy J., Duchene F., et al. Validation of a diagnosis model for differentiating bacterial from viral meningitis in infants and children under 3.5 years of age. Eur J Clin Microbiol Infect Dis 19 6 (2000) 418-421
56. Oostenbrink R., Moons K.G., Derksen-Lubsen A.G., et al. A diagnostic decision rule for management of children with meningeal signs. Eur J Epidemiol 19 2 (2004) 109-116
57. Bonsu B.K., and Harper M.B. Differentiating acute bacterial meningitis from acute viral meningitis among children with cerebrospinal fluid pleocytosis: a multivariable regression model. Pediatr Infect Dis J 23 6 (2004) 511-517
58. Ray P., Badarou-Acossi G., Viallon A., et al. Accuracy of the cerebrospinal fluid results to differentiate bacterial from non bacterial meningitis, in case of negative gram-stained smear. Am J Emerg Med 25 2 (2007) 179-184
59. Brivet F.G., Ducuing S., Jacobs F., et al. Accuracy of clinical presentation for differentiating bacterial from viral meningitis in adults: a multivariate approach. Intensive Care Med 31 12 (2005) 1654-1660
60. Chavanet P., Schaller C., Levy C., et al. Performance of a predictive rule to distinguish bacterial and viral meningitis. J Infect 54 4 (2007) 328-336
61. Marton K.I., and Gean A.D. The spinal tap: a new look at an old test. Ann Intern Med 104 6 (1986) 840-848
62. Tunkel A.R., Hartman B.J., Kaplan S.L., et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39 9 (2004) 1267-1284
63. Maxson S., Lewno M.J., and Schutze G.E. Clinical usefulness of cerebrospinal fluid bacterial antigen studies. J Pediatr 125 2 (1994) 235-238
64. Hayden R.T., and Frenkel L.D. More laboratory testing: greater cost but not necessarily better. Pediatr Infect Dis J 19 4 (2000) 290-292
65. Gerdes L.U., Jorgensen P.E., Nexo E., et al. C-reactive protein and bacterial meningitis: a meta-analysis. Scand J Clin Lab Invest 58 5 (1998) 383-393
66. Shimetani N., Shimetani K., and Mori M. Levels of three inflammation markers, C-reactive protein, serum amyloid A protein and procalcitonin, in the serum and cerebrospinal fluid of patients with meningitis. Scand J Clin Lab Invest 61 7 (2001) 567-574
67. Sirijaichingkul S., Tiamkao S., Sawanyawisuth K., et al. C reactive protein for differentiating bacterial from aseptic meningitis in Thai patients. J Med Assoc Thai 88 9 (2005) 1251-1256
68. Knudsen T.B., Larsen K., Kristiansen T.B., et al. Diagnostic value of soluble CD163 serum levels in patients suspected of meningitis: comparison with CRP and procalcitonin. Scand J Infect Dis 39 6 (2007) 542-553
69. Uzzan B., Cohen R., Nicolas P., et al. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med 34 7 (2006) 1996-2003
70. Gendrel D., Raymond J., Assicot M., et al. Measurement of procalcitonin levels in children with bacterial or viral meningitis. Clin Infect Dis 24 6 (1997) 1240-1242
71. Viallon A., Zeni F., Lambert C., et al. High sensitivity and specificity of serum procalcitonin levels in adults with bacterial meningitis. Clin Infect Dis 28 6 (1999) 1313-1316
72. Dubos F., Moulin F., Gajdos V., et al. Serum procalcitonin and other biologic markers to distinguish between bacterial and aseptic meningitis. J Pediatr 149 1 (2006) 72-76
73. Schwarz S., Bertram M., Schwab S., et al. Serum procalcitonin levels in bacterial and abacterial meningitis. Crit Care Med 28 6 (2000) 1828-1832
74. Hoffmann O., Reuter U., Masuhr F., et al. Low sensitivity of serum procalcitonin in bacterial meningitis in adults. Scand J Infect Dis 33 3 (2001) 215-218
75. Kost C.B., Rogers B., Oberste M.S., et al. Multicenter beta trial of the GeneXpert enterovirus assay. J Clin Microbiol 45 4 (2007) 1081-1086
76. Peltola H. Worldwide Haemophilus influenzae type b disease at the beginning of the 21st century: global analysis of the disease burden 25 years after the use of the polysaccharide vaccine and a decade after the advent of conjugates. Clin Microbiol Rev 13 2 (2000) 302-317
77. Albrich W.C., Baughman W., Schmotzer B., et al. Changing characteristics of invasive pneumococcal disease in Metropolitan Atlanta, Georgia, after introduction of a 7-valent pneumococcal conjugate vaccine. Clin Infect Dis 44 12 (2007) 1569-1576
78. Quagliarello V.J., and Scheld W.M. Treatment of bacterial meningitis. N Engl J Med 336 10 (1997) 708-716
79. Gutierrez Rodriguez M.A., Garcia Comas L., Rodero Garduno I., et al. Increase in viral meningitis cases reported in the Autonomous Region of Madrid, Spain, 2006. Euro Surveill 11 11 (2006) E0611033
80. Lee B.E., and Davies H.D. Aseptic meningitis. Curr Opin Infect Dis 20 3 (2007) 272-277
81. Kupila L., Vuorinen T., Vainionpaa R., et al. Etiology of aseptic meningitis and encephalitis in an adult population. Neurology 66 1 (2006) 75-80
82. Kardos K., and McErlean M. Recurrent aseptic meningitis associated with herpes simplex virus type 2. Am J Emerg Med 24 7 (2006) 885-886
83. Tapiainen T., Prevots R., Izurieta H.S., et al. Aseptic meningitis: Case definition and guidelines for collection, analysis and presentation of immunization safety data. Vaccine 31 25 (2007) 5793-5802
84. Periard D., Mayor C., Aubert V., et al. Recurrent ibuprofen-induced aseptic meningitis: evidence against an antigen-specific immune response. Neurology 67 3 (2006) 539-540
85. Rodriguez S.C., Olguin A.M., Miralles C.P., et al. Characteristics of meningitis caused by Ibuprofen: report of 2 cases with recurrent episodes and review of the literature. Medicine (Baltimore) 85 4 (2006) 214-220
86. Wambulwa C., Bwayo S., Laiyemo A.O., et al. Trimethoprim-sulfamethoxazole-induced aseptic meningitis. J Natl Med Assoc 97 12 (2005) 1725-1728
87. Ishida K., Uchihara T., and Mizusawa H. Recurrent aseptic meningitis: a new CSF complication of Sjogren's syndrome. J Neurol 254 6 (2007) 806-807
88. Miller E., Andrews N., Stowe J., et al. Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom. Am J Epidemiol 165 6 (2007) 704-709
89. Whitley R. Diagnosis and treatment of herpes simplex encephalitis. Annu Rev Med 32 (1981) 335-340
90. Aurelius E., Johansson B., Skoldenberg B., et al. Encephalitis in immunocompetent patients due to herpes simplex virus type 1 or 2 as determined by type-specific polymerase chain reaction and antibody assays of cerebrospinal fluid. J Med Virol 39 3 (1993) 179-186
91. Heyderman R.S. Early management of suspected bacterial meningitis and meningococcal septicaemia in immunocompetent adults-second edition. J Infect 50 5 (2005) 373-374
92. Kearney B.P., and Aweeka F.T. The penetration of anti-infectives into the central nervous system. Neurol Clin 17 4 (1999) 883-900
93. Karlowsky J.A., Thornsberry C., Critchley I.A., et al. Susceptibilities to levofloxacin in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis clinical isolates from children: results from 2000-2001 and 2001-2002 TRUST studies in the United States. Antimicrob Agents Chemother 47 6 (2003) 1790-1797
94. Draghi D.C., Sheehan D.J., Hogan P., et al. In vitro activity of linezolid against key gram-positive organisms isolated in the united states: results of the LEADER 2004 surveillance program. Antimicrob Agents Chemother 49 12 (2005) 5024-5032
95. Talan D.A., and Zibulewsky J. Relationship of clinical presentation to time to antibiotics for the emergency department management of suspected bacterial meningitis. Ann Emerg Med 22 11 (1993) 1733-1738
96. Bryan C.S., Reynolds K.L., and Crout L. Promptness of antibiotic therapy in acute bacterial meningitis. Ann Emerg Med 15 5 (1986) 544-547
97. Talan D.A., Guterman J.J., Overturf G.D., et al. Analysis of emergency department management of suspected bacterial meningitis. Ann Emerg Med 18 8 (1989) 856-862
98. Swartz M.N. Bacterial meningitis-a view of the past 90 years. N Engl J Med 351 18 (2004) 1826-1828
99. Weisfelt M., van de Beek D., and de Gans J. Dexamethasone treatment in adults with pneumococcal meningitis: risk factors for death. Eur J Clin Microbiol Infect Dis 25 2 (2006) 73-78
100. *. Crit Care Med 34 11 (2006) 2758-2765
101. Radetsky M. Duration of symptoms and outcome in bacterial meningitis: an analysis of causation and the implications of a delay in diagnosis. Pediatr Infect Dis J 11 9 (1992) 694-698 [discussion: 698-701]
102. Bonadio W.A. Medical-legal considerations related to symptom duration and patient outcome after bacterial meningitis. Am J Emerg Med 15 4 (1997) 420-423
103. Kennedy P.G. Viral encephalitis: causes, differential diagnosis, and management. J Neurol Neurosurg Psychiatr 75 Suppl 1 (2004) i10-i15
104. Whitley R.J., Alford C.A., Hirsch M.S., et al. Factors indicative of outcome in a comparative trial of acyclovir and vidarabine for biopsy-proven herpes simplex encephalitis. Infection 15 Suppl 1 (1987) S3-S8
105. Whitley R.J., Alford C.A., Hirsch M.S., et al. Vidarabine versus acyclovir therapy in herpes simplex encephalitis. N Engl J Med 314 3 (1986) 144-149
106. Skoldenberg B., Forsgren M., Alestig K., et al. Acyclovir versus vidarabine in herpes simplex encephalitis. Randomised multicentre study in consecutive Swedish patients. Lancet 2 8405 (1984) 707-711
107. Morawetz R.B., Whitley R.J., and Murphy D.M. Experience with brain biopsy for suspected herpes encephalitis: a review of forty consecutive cases. Neurosurgery 12 6 (1983) 654-657
108. Marton R., Gotlieb-Steimatsky T., Klein C., et al. Acute herpes simplex encephalitis: clinical assessment and prognostic data. Acta Neurol Scand 93 2-3 (1996) 149-155
109. Kamei S., Sekizawa T., Shiota H., et al. Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis. J Neurol Neurosurg Psychiatr 76 11 (2005) 1544-1549
110. Benson P.C., and Swadron S.P. Empiric acyclovir is infrequently initiated in the emergency department to patients ultimately diagnosed with encephalitis. Ann Emerg Med 47 1 (2006) 100-105
111. Koedel U., Scheld W.M., and Pfister H.W. Pathogenesis and pathophysiology of pneumococcal meningitis. Lancet Infect Dis 2 12 (2002) 721-736
112. Fitch M.T., Doller C., Combs C.K., et al. Cellular and molecular mechanisms of glial scarring and progressive cavitation: in vivo and in vitro analysis of inflammation-induced secondary injury after CNS trauma. J Neurosci 19 19 (1999) 8182-8198
113. Fitch M.T., and Silver J. CNS injury, glial scars, and inflammation: Inhibitory extracellular matrices and regeneration failure. Exp Neurol (2007 May 31) [Epub ahead of print]
114. van de Beek D. Brain teasing effect of dexamethasone. Lancet Neurol 6 3 (2007) 203-204
115. van de Beek D., and de Gans J. Dexamethasone in adults with community-acquired bacterial meninigitis. Drugs 66 4 (2006) 415-427
116. Meyding-Lamade U.K., Oberlinner C., Rau P.R., et al. Experimental herpes simplex virus encephalitis: a combination therapy of acyclovir and glucocorticoids reduces long-term magnetic resonance imaging abnormalities. J Neurovirol 9 1 (2003) 118-125
117. Jubelt B. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. Curr Neurol Neurosci Rep 6 6 (2006) 451-452
118. de Gans J., and van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med 347 20 (2002) 1549-1556
119. van de Beek D., de Gans J., McIntyre P., et al. Steroids in adults with acute bacterial meningitis: a systematic review. Lancet Infect Dis 4 3 (2004) 139-143
120. van de Beek D., de Gans J., McIntyre P., et al. Corticosteroids in acute bacterial meningitis. Cochrane Database Syst Rev 1 (2007) CD004405
121. Begg N., Cartwright K.A., Cohen J., et al. Consensus statement on diagnosis, investigation, treatment and prevention of acute bacterial meningitis in immunocompetent adults. British Infection Society Working Party. J Infect 39 1 (1999) 1-15
122. McIntyre P.B., Berkey C.S., King S.M., et al. Dexamethasone as adjunctive therapy in bacterial meningitis. A meta-analysis of randomized clinical trials since 1988. JAMA 278 11 (1997) 925-931
123. Sergerie Y., Boivin G., Gosselin D., et al. Delayed but not early glucocorticoid treatment protects the host during experimental herpes simplex virus encephalitis in mice. J Infect Dis 195 6 (2007) 817-825