Bacterial Meningitis: Pathogenesis, Pathophysiology, and Progress

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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 . . .