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Related Concept Videos

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Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Related Experiment Video

Updated: Apr 4, 2026

Inducing Meningococcal Meningitis Serogroup C in Mice via Intracisternal Delivery
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Corticosteroids for acute bacterial meningitis.

Matthijs C Brouwer1, Peter McIntyre, Kameshwar Prasad

  • 1Department of Neurology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center University of Amsterdam, P.O. Box 22660, Amsterdam, Netherlands, 1100 DE.

The Cochrane Database of Systematic Reviews
|September 13, 2015
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Corticosteroids significantly reduced hearing loss and neurological sequelae in bacterial meningitis patients, but did not impact overall mortality. The benefits were primarily observed in high-income countries, with no significant effect noted in low-income settings.

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Pharmacology

Background:

  • Bacterial meningitis causes inflammation in the subarachnoid space, impacting patient outcomes.
  • Corticosteroids are known to modulate inflammatory responses.

Purpose of the Study:

  • To evaluate the efficacy of adjuvant corticosteroid therapy versus placebo in treating acute bacterial meningitis.
  • Assessed impact on mortality, hearing loss, and neurological sequelae across all age groups.

Main Methods:

  • Conducted a systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched multiple databases including CENTRAL, MEDLINE, EMBASE, Web of Science, CINAHL, and LILACS.
  • Performed subgroup analyses based on age, causative organisms, country income, and study quality.

Main Results:

  • Corticosteroids showed a non-significant reduction in overall mortality but significantly decreased severe hearing loss, any hearing loss, and neurological sequelae.
  • Beneficial effects on hearing loss and neurological sequelae were more pronounced in high-income countries.
  • Reduced mortality was observed specifically in Streptococcus pneumoniae meningitis cases.
  • An increased risk of recurrent fever was associated with corticosteroid use.

Conclusions:

  • Adjuvant corticosteroids are effective in reducing hearing loss and neurological sequelae in bacterial meningitis.
  • Corticosteroid therapy is supported for patients in high-income countries but lacks demonstrated benefit in low-income settings.
  • Overall mortality reduction was not statistically significant.