Bacterial meningitis. Some aspects of diagnosis and treatment.

Antimicrobial therapy has made few more drama- tic conquests than that of bacterial meningitis, which it has transformed from the almost univer- sally fatal illness of 30 years ago into one with a relatively low mortality. Yet the disease, which has its greatest impact in early childhood, poses a Infecting organisms After the first 2 months of life three organisms predominate: Haemophilus influenzae, Neisseria meningitidis, and Diplococcus pneumoniae. They are responsible for most cases of childhood meningitis. In the neonatal period and the ensuing 4 weeks virtually any bacteria can cause the disease, though Gram-negative organisms are most evident in many parts of the world. Some reasons for this have been discussed previously Neonatal meningitis caused by Esch. coli is associ- ated with a significantly higher morbidity and 674 copyright.