Meningitis as it presents in the elderly: diagnosis and care

The clinical presentation of bacterial meningitis in the elderly is often more subtle than in younger patients. Delay in diagnosis and treatment contributes significantly to morbidity and mortality. The presence of fever and a change in mental status in an elderly patient should raise suspicion for the presence of meningitis and prompt examination of the cerebrospinal fluid. Knowledge of the bacterial pathogens causing meningitis in this age group and administration of the recommended antimicrobial agents can greatly reduce morbidity and neurologic sequelae. This review updates the primary care physician in the diagnosis and management of this serious infection.