Community-acquired Purulent Meningitis in Adults

Community-acquired bacterial meningitis in adults is a diagnostic and therapeutic emergency due to its high morbidity and mortality. It is less frequent than viral meningitis but more serious. Mortality can reach 20% in the acute phase and sequelae affect around 30% of patients. The diagnosis of purulent meningitis should be suspected on initial clinical examination in the presence of fever associated with signs of neuromeningeal damage requiring rapid and appropriate management. Community-acquired purulent meningitis is defined as an infectious syndrome with cloudy cerebrospinal fluid on lumbar puncture. The main germs responsible for community-acquired bacterial meningitis in adults are Streptococcus pneumoniae (S.pneumoniae) and Neisseria meningitidis (N.meningitidis).In recent years several authors have reported a change in the epidemiological profile of bacterial meningitis following the introduction of new vaccines. These changes have influenced recommendations for the management of this serious disease.