Speed in diagnosis and treatment is essential

Nearly one in four adults with acute bacterial meningitis will die, and many survivors sustain neurological deficits.1 2 The outcome has not changed since the early 1960s despite the introduction of potent antibiotics and specialised intensive care units.3

The prognosis is worse with a delay in management.4 Consequently, the outcome depends on whether the attending physician suspects acute bacterial meningitis, and whether the healthcare system is set up to make a rapid, accurate diagnosis and initiate fast and effective treatment.

In this respect, standardised guidelines such as those recently issued by the working party under the British Infection Society are invaluable.5 These guidelines make recommendations for the management of adults with suspected or diagnosed acute bacterial meningitis or meningococcal disease and for the …