Bacterial Infections

This chapter presents a discussion on the clinical aspect of the bacterial infections. The clinical hallmarks of bacterial meningitis are stiff neck, headache, fever, photophobia, malaise, vomiting, alteration of consciousness, confusion, irritability, and rarely acute psychosis. Meningismus is maintained in the majority of the patients with altered consciousness even if comatose. Diagnosis of bacterial meningitis is established by-identification of the bacterial microorganism in the cerebrospinal fluid (CSF) by culture, microscopy of a Gram-stained smear, or antigen detection using latex particle agglutination test; and/or elevated CSF cell count of more than 1000 white blood cells/μL and CSF consisting of more than 60% polymorphonuclear leukocytes, elevated protein content, and a CSF-blood glucose ratio of less than 0.3. Bacterial microorganisms are detectable in the CSF in 70-80% of the patients by at least one of the mentioned methods. The most common etiologic agents of bacterial meningitis are Neisseria meningitidis and Streptococcus pneumoniae. The chapter discusses complications in the central nervous system, general management of a patient with suspected bacterial meningitis, and several therapies. The discussion on therapies include antibiotic therapy, adjunctive therapy, empiric antibiotic therapy/choice of antibiotics, and others.