Bacterial meningitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Aysha Anwar, M.B.B.S[2]

## Overview

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There is no specific classification system for bacterial meningitis. However, it may be classified according to the age group, causative agent, clinical presentation, severity and duration of illness. Prognosis of bacterial meningitis may depend on the severity of the disease and causative agent.[1][2][3][4][5][6][7]

## Classification

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Bacterial meningitis may be classified according to the age group, causative agent, severity, and duration of disease.[1][2][3][4][5][6][7]

According to age group

Age group |  Etiological agent |  Clinical features
Neonates and infants[6][4] |

* Group B streptococcus
* E coli
* Listeria monocytogenes
* Streptococcus pneumoniae

* Hypothermia or hyperthermia
* Jaundice
* Irritability
* Bulging fontanelle
* Vomiting
* High pitched cry

Adults[6][4] |

* Streptococcus pneumoniae
* Neisseria meningitidis
* Hemophilus influenza type b
* Listeria monocytogenes

* Fever
* Neck stiffness
* Headache
* Nausea and Vomiting
* Papilledema
* Bradycardia

Elderly[6][4] |

* Streptococcus pneumoniae
* Listeria monocytogenes
* Neisseria meningitides
* Hemophilus influenza type b

* Hypothermia or hyperthermia
* Altered mental status
* Decreased oral intake
* Disrupted sleep
* Neck stiffness

According to severity of the disease
Mild  |

* Early diagnosis and treatment
* Responds to medical treatment
* Typical clinical presentation
* Immunocompetent
* Good prognosis

Moderate  |

* May present late with typical or atypical symptoms
* May present with complications
* Variable response to treatment

Severe  |

* Presents with complications or prolonged illness
* Immunocompromised
* Common in extremes of age
* Delayed diagnosis and treatment
* Surgical treatment may be required in addition to medical treatment
* Increased morbidity and mortality

According to the duration of disease
Acute[4][5] |

* Lasts less than 4 weeks
* Patient acutely ill
* Seeks medical treatment early due to sudden deterioration

Chronic [2][3] |

* Lasts more than 4 weeks
* Gradual deterioration of patient
* Prolonged history of atypical symptoms
* Common in older patients

Recurrent[1][8] |

* Multiple episodes which lasts less than 4 weeks
* History of incompliance to medication
* Common in young children
* Anatomical defect or immunosuppression may be the underlying cause

## References

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1. ↑ 1.0 1.1 1.2 Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N (1996). "Recurrent bacterial meningitis". Eur J Pediatr. 155 (1): 26–30. PMID 8750806.CS1 maint: Multiple names: authors list (link)
2. ↑ 2.0 2.1 2.2 Boos C, Daneshvar C, Hinton A, Dawes M (2004). "An unusual case of chronic meningitis". BMC Fam Pract. 5: 21. doi:10.1186/1471-2296-5-21. PMC 524513. PMID 15469610.CS1 maint: Multiple names: authors list (link)
3. ↑ 3.0 3.1 3.2 Baldwin KJ, Zunt JR (2014). "Evaluation and treatment of chronic meningitis". Neurohospitalist. 4 (4): 185–95. doi:10.1177/1941874414528940. PMC 4212414. PMID 25360204.
4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.CS1 maint: Multiple names: authors list (link)
5. ↑ 5.0 5.1 5.2 Mace SE (2008). "Acute bacterial meningitis". Emerg Med Clin North Am. 26 (2): 281–317, viii. doi:10.1016/j.emc.2008.02.002. PMID 18406976.
6. ↑ 6.0 6.1 6.2 6.3 6.4 https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017
7. ↑ 7.0 7.1 Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL; et al. (2011). "Bacterial meningitis in the United States, 1998-2007". N Engl J Med. 364 (21): 2016–25. doi:10.1056/NEJMoa1005384. PMID 21612470.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
8. ↑ Wang HS, Kuo MF, Huang SC (2005). "Diagnostic approach to recurrent bacterial meningitis in children". Chang Gung Med J. 28 (7): 441–52. PMID 16231527.CS1 maint: Multiple names: authors list (link)

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