Bacterial meningitis remains a serious disease in adults, with S. pneumoniae and N. meningitidis causing the majority of cases. The initial approach involves assessing for the classic triad of symptoms, but lumbar puncture may be deferred if neuroimaging is warranted due to concerns for mass lesions or decreased consciousness. Empiric antibiotic therapy should begin as soon as possible, often in combination with vancomycin and dexamethasone, which reduces mortality and morbidity when given early in treatment. Outcomes depend on severity of symptoms and causative organism, with pneumococcal meningitis carrying the highest fatality and long-term complication rates.

1. Meningitis in Adults Dr. Dino Sgarabotto Malattie Infettive e Tropicali Azienda Ospedaliera di Padova

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