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AKU Student

no

Document Type

Review Article

Abstract

Background and objective: Bacterial meningitis remains a neurological emergency in adults, with substantial mortality and long-term sequelae, including cognitive impairment, hearing loss, seizures, and focal deficits. The objective of this narrative review was to summarize current evidence on predictors of neurological disability and highlight strategies for prevention and long-term care.

Methods: A narrative literature review was conducted using PubMed, Scopus, and Google Scholar for English-language studies published between 2000 and 2025. Keywords included bacterial meningitis, neurological sequelae, predictors, and adults. A total of 40 studies were included after screening 200 abstracts . Key prospective studies, clinical trials, and reviews were prioritized, and additional references were identified from bibliographies of relevant articles and guidelines.

Results: Clinical predictors of poor neurological outcome include advanced age, low Glasgow Coma Scale score, seizures at presentation, and delayed antibiotic initiation. Laboratory predictors include low CSF glucose and elevated CSF protein. Radiological findings such as infarcts, hydrocephalus, and ventriculitis are associated with long-term disability. Among pathogens, Streptococcus pneumoniae carries the highest risk of neurological sequelae. Preventive strategies with documented benefit include timely antibiotic therapy, adjunctive corticosteroids, vaccination programs, structured neurorehabilitation, and ongoing follow-up.

Conclusion: Early recognition of clinical, laboratory, and radiological prognostic indicators can reduce neurological disability in adults with bacterial meningitis. Future priorities should focus on validating biomarkers, establishing longitudinal registries, and exploring artificial intelligence based risk stratification to guide personalized care.

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