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Dtsch Med Wochenschr 2016; 141(07): 470-473
DOI: 10.1055/s-0042-103255
Klinischer Fortschritt
Infektiologie
© Georg Thieme Verlag KG Stuttgart · New York

Neues zur akuten bakteriellen Meningitis

Acute bacterial meningitis: an update
Matthias Klein
1   Zentrale Notaufnahme, Klinikum Grosshadern, Ludwig-Maximilians Universität
,
Hans-Walter Pfister
2   Neurologische Klinik und Poliklinik, Klinikum Großhadern, Ludwig-Maximilians Universität
› Author Affiliations
Further Information

Publication History

Publication Date:
31 March 2016 (online)

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Zusammenfassung

Bei Verdacht auf akute bakterielle Meningitis soll eine schnelle diagnostische Liquorpunktion angestrebt werden. Nur bei fokalen neurologischen Defiziten, Vigilanzminderung, epileptischen Anfällen innerhalb der Vorwoche und bekannter Immunsuppression soll nach aktueller Datenlage vor Lumbalpunktion eine zerebrale Bildgebung des Schädels mit der Frage nach Kontraindikationen für eine lumbale Liquorentnahme durchgeführt werden. Entscheidend für die Prognose bei akuter bakterieller Meningitis ist unter anderem ein schneller Beginn einer antibiotischen Therapie, möglichst innerhalb einer Stunde nach Krankenhausaufnahme.

Abstract

In patients with clinically suspected acute bacterial meningitis, physicians should aim for a quick diagnostic workup including lumbar puncture. Cerebral imaging before lumbar puncture is only indicated in patients with focal neurologic deficits, impaired consciousness, epileptic seizures within one week before presentation or a history of immunosuppression. One important prognostic factor is a rapid initiation of an empiric antibiotic therapy which should best be started within 1 hour after hospital admission.

Schlüsselwörter

bakterielle Meningitis - Streptococcus pneumoniae - Neisseria meningitidis - ZNS-Infektion

Keywords

bacterial meningitis - Streptococcus pneumoniae - Neisseria meningitidis - cns infection
 

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