Neurology Unit, Department of Medicine, Faculty of Medicine, University of Garyounis, Benghazi, Libya
Garyounis Medical Journal Vol. 22, No.2. 2005:09-16
Meningitis is a potentially life-threatening infection of the meninges, the tough layer of tissue that surrounds the brain and the spinal cord. Few conditions are as respectfully feared as acute bacterial meningitis. and by so many different types of physicians. family practitioners. pediatricians, neurologists. infectious disease specialists, emergency physicians and neurosurgeons caring for their post-operative patients. Over the past decade, a fuller understanding of the pathophysiology of bacterial meningitis at the molecular level has led to a greater interest in adjunctive measures in the management of this infection. The major emphasis has been on modulating the host response to infection, which itself may be contributing to tissue damage that results in neurological dysfunction. Dexamethasone has been the agent primarily evaluated in clinical trials. It is unlikely that more potent antibiotics or achieving greater concentrations of antibiotics in cerebrospinal fluid will result in any better outcome than is achieved with antibiotics currently available. Dexamethasone, before or with the first dose of antibiotic, is likely to be one of the most significant practice changes that will benefit many adults and children with common types of acute bacterial meningitis.
Keywords: bacterial meningitis. dexamethasone. Haemophilus influenzae