Chapter 68 - Bacterial meningitis and focal suppurative intracranial infections in children

Summary

This chapter discusses the burden and the changing epidemiology of acute bacterial meningitis (ABM) and the incidence of epilepsy following ABM and intracranial abscesses in children. It identifies the predictive factors, therapeutic implications, and prevention of ABM and consequent epilepsy in these conditions. Of the acquired causes, central nervous system (CNS) infections are common in childhood and include bacterial meningitis, viral encephalitis, and intracranial suppurative infections such as brain abscess, subdural empyema, and cranial epidural abscess. The changing epidemiology of bacterial meningitis and the emergence of antibiotic resistant strains of pneumococcal meningitis demand regional guidelines for initial empirical treatment of ABM based on the knowledge of regional epidemiologic factors. The effectiveness of administration of dexamethasone before the first effective parenteral antibiotic dose in reducing neurologic and/or audiologic sequelae in children with Haemophilus influenzae type B (HiB) meningitis has been demonstrated in several studies.