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Clinical Microbiology Reviews, July 2008, p. 519-537, Vol. 21, No. 3
0893-8512/08/$08.00+0     doi:10.1128/CMR.00009-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Epidemiology, Etiology, Pathogenesis, and Diagnosis of Recurrent Bacterial Meningitis

Marc Tebruegge and Nigel Curtis*

Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, Australia; and Murdoch Childrens Research Institute, Parkville, Australia

Recurrent bacterial meningitis is a rare phenomenon and generally poses a considerable diagnostic challenge to the clinician. Ultimately, a structured approach and early diagnosis of any underlying pathology are crucial to prevent further episodes and improve the overall outcome for the affected individual. In this article, we are reviewing the existing literature on this topic over the last two decades, encompassing 363 cases of recurrent bacterial meningitis described in 144 publications. Of these cases, 214 (59%) were related to anatomical problems, 132 (36%) were related to immunodeficiencies, and 17 (5%) were related to parameningeal infections. The review includes a detailed discussion of the underlying pathologies and microbiological aspects as well as recommendations for appropriate diagnostic pathways for investigating this unusual entity.

* Corresponding author. Mailing address: Department of Paediatrics, Royal Children's Hospital Melbourne, Flemington Rd., Parkville, Victoria 3052, Australia. Phone: 61-3-9345 4545. Fax: 61-3-9345 6667. E-mail: nigel.curtis{at}rch.org.au

Clinical Microbiology Reviews, July 2008, p. 519-537, Vol. 21, No. 3
0893-8512/08/$08.00+0     doi:10.1128/CMR.00009-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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