Management of meningitis.

Meningitis occurs mostly in previously fit young people and, because it causes significant mortality and morbidity, must be recognised and treated promptly. Overall, the mortality of bacterial meningitis in adults is 25%, with significant sequelae of disease including deafness and cognitive loss.1 In bacterial meningitis, the first step in pathogenesis is colonisation of the nasopharynx, followed by haematogenous spread to other sites including the meninges.2 In viral meningitis, acquisition is mostly faecal-oral, followed by viraemia.