MENINGITIS IN OLDER PATIENTS - HOW TO DIAGNOSE AND TREAT A DEADLY INFECTION

Studies of bacterial meningitis have documented a peak of incidence am ong persons age 60 and older. The most common bacterial pathogens in t hese patients differ from those seen in children. Presentation of meni ngitis in older patients may be atypical; fever is not a consistent fi nding, and nonspecific symptoms such as confusion are often seen. Nuch al rigidity is not as sensitive nor as specific as in younger patients . Definitive diagnosis relies on interpretation of CSF studies. Ampici llin plus a third-generation cephalosporin should be administered for community-acquired meningitis until Gram's stain and culture results r eturn. Cases of S pneumoniae meningitis may require varying strategies , based upon the degree of penicillin resistance.