Journal of Clinical Images and Case Reports

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Imaging in Bacterial Meningitis

Meningitis is a clinical syndrome characterized by inflammation of the meninges. The most common cause of meningeal inflammation is bacterial or viral infection. Most cases of bacterial meningitis are localized over the dorsum of the brain; however, under certain conditions, meningitis may be concentrated at the base of the brain, as with fungal diseases and tuberculosis. Bacterial meningitis must be the first and foremost consideration in the differential diagnosis of patients with headache, neck stiffness, fever, and altered mental status. Acute bacterial meningitis is a medical emergency, and delays in instituting effective antimicrobial therapy result in increased morbidity and mortality. The decision to obtain a brain CT scan before LP should not delay the institution of antibiotic therapy; such delay can increase mortality. Pyogenic meningitis, also referred as bacterial meningitis, is a life-threatening CNS infectious disease affecting the meninges, with elevated mortality and disability rates. Three bacteria (Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis) account for the majority of cases[1,2]. Neuroimaging can identify conditions that may predispose to bacterial meningitis; thus, it is indicated in patients who have evidence of head trauma, sinus or mastoid infection, skull fracture, and congenital anomalies. In addition, neuroimaging studies are typically used to identify and monitor complications of meningitis, such as hydrocephalus, subdural effusion, empyema, and infarction and to exclude parenchymal abscess and ventriculitis

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