Meningitis and encephalitis are medical emergencies that can be difficult to recognise. Although rare, they carry considerable mortality and morbidity, particularly when diagnosis and treatment are delayed. Both are notifiable diseases. This article will summarise the best practice approach to assessment and management in primary care.
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References
1.
BaraffL. J.LeeS. I.SchrigerL. D. (1993) Outcomes of bacterial meningitis in children: A meta-analysis. Paediatric Infectious Disease Journal12(5): 389–394. doi: 10.1097/00006454-199305000-00008.
BrooksR.WoodsC. W.BenjaminJ. D.JrRosensteinN. E. (2006) Increased case-fatality rate associated with outbreaks of Neisseria meningitidis infection, compared with sporadic meningococcal disease, in the United States, 1994–2002. Clinical Infectious Disease Journal43(1): 49–54. Retrieved from www.ncbi.nlm.nih.gov/pubmed/16758417.
GranerodJ.CousensS.DaviesN.CrowfordN.ThomasS. (2013) New estimates of incidence of encephalitis in England. EID Journal19(9): 1455–1462. doi: 10.3201/eid1909.130064.
7.
GranerodJ.TamC. C.CrowcroftN. S.DaviesN. W. S.BorchertM.ThomasS. L. (2010) Challenge of the unknown: A systematic review of acute encephalitis in non-outbreak situations. Neurology75(10): 924–932. doi: 10.1212/WNL.0b013e3181f11d65.
8.
HammerS. M.ConnollyK. J. (1992) Viral aseptic meningitis in the United States: Clinical features, viral aetiologies and differential diagnosis. Current Clinical Top Infectious Diseases12: 1–25.
HsuH. E.ShuttK. A.MooreM. R.BeallB. W.BennettN. M.CraigA. S.HarrisonL. H. (2009) Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. New England Journal of Medicine360(3): 244–256. doi: 10.1056/NEJMoa0800836.
11.
Joint Formulary Committee. (2015) British National Formulary (69). London: BMJ Group and Pharmaceutical Press.
12.
LadhaniS. N.BeebeejaunK.LucidarmeJ.CampbellH.GrayS.KaczmarskiE.BorrowR. (2015) Increase in endemic Neisseria meningitidis capsular group W ST-11 complex associated with severe invasive disease in England and Wales. Clinical Infectious Diseases60(4): 578–585. doi: 10.1093/cid/ciu881.
13.
LevitzR. E. (1998) Herpes simplex encephalitis: A review. Heart & Lung27(3): 209–212. doi: 10.1016/S0147-9563(98)90009-7.
14.
MaceS. E. (2009) Acute bacterial meningitis. Emergency Medicine Clinics of North America26(2): 281–317. doi: 10.1016/j.emc.2008.02.002.
15.
Meningitis Research Foundation. Lessons from research for doctors in training. Recognition and early management of meningococcal disease in children and young people. Edition 3A. Retrieved from www.meningitis.org/assets/x/50156.
16.
Meningitis Research Foundation (2014). Meningococcal meningitis and septicaemia. Guidance Notes. Diagnosis and treatment in general practice. Retrieved from http://www.meningitis.org/assets/x/50631.
ThigpenM. C.WhitneyC. G.MessonnierN. E.ZellE. R.LynfieldR.HadlerJ.SchuchatA. (2011) Bacterial meningitis in the United States, 1998–2007. New England Journal of Medicine364(21): 2016–2025. doi: 10.1056/NEJMoa1005384.
22.
ThompsonM. J.NinisN.PereraR.Mayon-WhiteR.PhilipsC.BaileyL.LevinM. (2006) Clinical recognition of meningococcal disease in children and adolescents. Lancet367(9508): 397–403. doi: 10.1016/S0140-6736(06)67932-4.
23.
VenkatesanA.TunkelA. R.BlochK. C.LauringA. S.SejvarJ.BitnunA.GlaserC. A. (2013) Case definitions, diagnostic algorithms, and priorities in encephalitis: Consensus statement of the International Encephalitis Consortium. Clinical Infectious Diseases57(8): 1114–1128. doi: 10.1093/cid/cit458.
