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Infectious meningitis and encephalitis: A primer for acute care practitioners
Martin Beed1, Chit Wong1, Rob A Dineen1
1Nottingham University Hospitals, UK.
Journal of the Intensive Care Society
|April 9, 2026
Summary
Meningitis and encephalitis are serious brain infections that are often misdiagnosed. Early recognition and prompt treatment are crucial for improving outcomes and reducing the high mortality and morbidity associated with these central nervous system infections.
Area of Science:
- Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Meningitis and encephalitis are severe central nervous system (CNS) infections affecting all age groups.
- These conditions are prone to misdiagnosis, leading to devastating outcomes, high morbidity, and mortality.
- CNS infections represent a significant cause of admission to intensive care units (ICUs), with substantial associated healthcare costs and resource utilization.
Purpose of the Study:
- To provide a foundational understanding of meningitis and encephalitis for healthcare professionals involved in sepsis care.
- To highlight the diagnostic challenges, clinical presentations, and epidemiological impact of these CNS infections.
- To emphasize the critical importance of early recognition and timely management in improving patient outcomes.
Main Methods:
- Review of clinical presentation, diagnostic modalities, and treatment strategies for meningitis and encephalitis.
- Discussion of epidemiological data, including incidence, mortality, and long-term disability rates.
- Emphasis on the role of history, physical examination, lumbar puncture (LP), and neuroimaging (CT/MRI) in diagnosis.
Main Results:
- Meningitis affects millions worldwide annually, with significant mortality and morbidity, including high rates of permanent disability.
- Delayed diagnosis and treatment (over 4 hours) are associated with increased mortality and intracranial complications.
- Early administration of appropriate antimicrobials (within 1 hour) and supportive care significantly improve patient outcomes.
Conclusions:
- Meningitis and encephalitis are life-threatening infections requiring prompt diagnosis and management.
- Adherence to established diagnostic and treatment protocols, including rapid antimicrobial administration, is essential.
- Effective management hinges on the "chain-of-survival" principles, emphasizing early recognition and intervention to mitigate severe consequences.
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