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Prognosis and complications of acute purulent meningitis
1. Big picture
Acute purulent (bacterial) meningitis is a neurological emergency. Even with treatment it carries significant mortality and a high rate of permanent neurological sequelae. The exam wants you to know what can go wrong (complications) and what determines outcome (prognosis).
Core exam idea: Outcome depends on the organism, the patient's age and immune state, and — above all — how quickly effective antibiotics (and dexamethasone) are started. Delay in treatment is the most modifiable predictor of death and disability.
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