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Intensive Care Unit Management of Meningitis and Encephalitis
Destiny Marquez1, Neha Subhash Dangayach2
1Neurocritical Care Division, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
None:
Meningitis and encephalitis are neurologic emergencies that require rapid recognition and treatment. Prompt diagnosis and administration of antimicrobials, alongside adjuvant steroids in select cases, are crucial for treatment and improvement in outcomes. Severe complications of meningitis and encephalitis may include seizures, hyponatremia, elevated intracranial pressure (ICP), cerebral edema and herniation, vasculitis and cerebral ischemia. Critical care management focuses on appropriate antimicrobials, seizure control, ICP monitoring and optimization, and, if severe, neurosurgical intervention for cerebrospinal fluid diversion or decompression.
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For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
