Bacterial Meningitis: Pathogenesis, Pathophysiology, and Progress

Abstract

FIFTY years after the advent of antibiotics for clinical use, bacterial meningitis remains an important cause of morbidity and mortality. As such, it represents a unique human infectious disease, because the pathophysiologic effects of disease progression and suboptimal outcomes occur despite bacteriologic cure of the infection.¹ Specifically, the mortality rate for adults who have Streptococcus pneumoniae meningitis remains 20 to 30 percent,^{2 , 3} with neurologic morbidity affecting half of survivors.⁴ The incidence of persistent sensorineural hearing loss in children who survive bacterial meningitis is 10 percent (31 percent of those with S. pneumoniae are affected) — a finding with critical implications . . .