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Bacterial meningitis in adults continues to carry the high mortality rates described in numerous retrospective studies of this disease. Now, researchers in Amsterdam have conducted a unique prospective study of clinical features and prognostic factors in adults with community-acquired bacterial meningitis. From October 1998 through April 2002, they evaluated all patients aged >16 years with this condition in the Netherlands (696 cerebrospinal fluid [CSF] culture-confirmed episodes, 671 patients).
Of the characteristic findings (fever, stiff neck, mental status change, headache), two were present in 95% of episodes; the first three were present in only 44%. Patients had focal neurologic deficits on hospital admission in 33% of episodes, were …