Afeerah Mumtaz MD
ECFMG certified, IM Residency Applicant, Research associate at AINeuroCare, KEMU'20
The classic triad for bacterial meningitis includes Fever, Neck stiffness, and Altered mental status, however, it is present in less than 50% of the patients with bacterial meningitis. Proof of bacteria in CSF by either Gram staining or positive culture is key to the diagnosis of bacterial meningitis. Delayed initiation of antibiotic therapy has been shown to significantly increase mortality and adverse outcomes at 3 months.
CNS vasculitis is classified as Primary angiitis of CNS, Systemic vasculitis involving CNS, Secondary (Secondary CNS vasculitis). Treatment is aggressive for the first 6-8 months and then tapered depending upon the resolution of symptoms. Monitoring of treatment is necessary. MRI should be done after 4-6 weeks of initiation of therapy and afterward done every 3-4 months in the first year of treatment.