[Classical and current aspects of purulent meningitis]

Even today acute purulent meningitis is a life-threatening disease requiring immediate diagnosis and therapy. Despite the availability of bactericidal antibiotics, the mortality has not changed within the last 20 years. A therapeutic approach interfering specifically with the pathogenesis of inflammation is necessary in order to prevent long-term neurological sequelae and death associated with bacterial meningitis. In this paper we discuss the present level of understanding of antibiotics and adjunctive therapy, especially with regard to the molecular pathophysiological events occurring during a CNS infection.