Bacterial meningitis classification: Difference between revisions

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Latest revision as of 20:34, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S [2]

Overview

There is no specific classification system for bacterial meningitis. However, it may be classified according to the age group, causative agent, clinical presentation, severity and duration of illness. Prognosis of bacterial meningitis may depend on the severity of the disease and causative agent.^[1]^[2]^[3]^[4]^[5]^[6]^[7]

Classification

Bacterial meningitis may be classified according to the age group, causative agent, severity, and duration of disease.^[1]^[2]^[3]^[4]^[5]^[6]^[7]


Age group	Etiological agent	Clinical features
According to age group
Neonates and infants^[6]^[4]	Group B streptococcus E coli Listeria monocytogenes Streptococcus pneumoniae	Hypothermia or hyperthermia Jaundice Irritability Bulging fontanelle Vomiting High pitched cry
Adults^[6]^[4]	Streptococcus pneumoniae Neisseria meningitidis Hemophilus influenza type b Listeria monocytogenes	Fever Neck stiffness Headache Nausea and Vomiting Papilledema Bradycardia
Elderly^[6]^[4]	Streptococcus pneumoniae Listeria monocytogenes Neisseria meningitides Hemophilus influenza type b	Hypothermia or hyperthermia Altered mental status Decreased oral intake Disrupted sleep Neck stiffness
According to severity of the disease
Mild	Early diagnosis and treatment Responds to medical treatment Typical clinical presentation Immunocompetent Good prognosis
Moderate	May present late with typical or atypical symptoms May present with complications Variable response to treatment
Severe	Presents with complications or prolonged illness Immunocompromised Common in extremes of age Delayed diagnosis and treatment Surgical treatment may be required in addition to medical treatment Increased morbidity and mortality
According to the duration of disease
Acute^[4]^[5]	Lasts less than 4 weeks Patient acutely ill Seeks medical treatment early due to sudden deterioration
Chronic ^[2]^[3]	Lasts more than 4 weeks Gradual deterioration of patient Prolonged history of atypical symptoms Common in older patients
Recurrent^[1]^[8]	Multiple episodes which lasts less than 4 weeks History of incompliance to medication Common in young children Anatomical defect or immunosuppression may be the underlying cause

References

↑ ^1.0 ^1.1 ^1.2 Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N (1996). "Recurrent bacterial meningitis". Eur J Pediatr. 155 (1): 26–30. PMID 8750806.
↑ ^2.0 ^2.1 ^2.2 Boos C, Daneshvar C, Hinton A, Dawes M (2004). "An unusual case of chronic meningitis". BMC Fam Pract. 5: 21. doi:10.1186/1471-2296-5-21. PMC 524513. PMID 15469610.
↑ ^3.0 ^3.1 ^3.2 Baldwin KJ, Zunt JR (2014). "Evaluation and treatment of chronic meningitis". Neurohospitalist. 4 (4): 185–95. doi:10.1177/1941874414528940. PMC 4212414. PMID 25360204.
↑ ^4.0 ^4.1 ^4.2 ^4.3 ^4.4 ^4.5 Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.
↑ ^5.0 ^5.1 ^5.2 Mace SE (2008). "Acute bacterial meningitis". Emerg Med Clin North Am. 26 (2): 281–317, viii. doi:10.1016/j.emc.2008.02.002. PMID 18406976.
↑ ^6.0 ^6.1 ^6.2 ^6.3 ^6.4 https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017
↑ ^7.0 ^7.1 Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL; et al. (2011). "Bacterial meningitis in the United States, 1998-2007". N Engl J Med. 364 (21): 2016–25. doi:10.1056/NEJMoa1005384. PMID 21612470.
↑ Wang HS, Kuo MF, Huang SC (2005). "Diagnostic approach to recurrent bacterial meningitis in children". Chang Gung Med J. 28 (7): 441–52. PMID 16231527.

Template:WikiDoc Sources

[pmid8750806-1] 1.0 ^1.1 ^1.2 Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N (1996). "Recurrent bacterial meningitis". Eur J Pediatr. 155 (1): 26–30. PMID 8750806.

[pmid15469610-2] 2.0 ^2.1 ^2.2 Boos C, Daneshvar C, Hinton A, Dawes M (2004). "An unusual case of chronic meningitis". BMC Fam Pract. 5: 21. doi:10.1186/1471-2296-5-21. PMC 524513. PMID 15469610.

[pmid25360204-3] 3.0 ^3.1 ^3.2 Baldwin KJ, Zunt JR (2014). "Evaluation and treatment of chronic meningitis". Neurohospitalist. 4 (4): 185–95. doi:10.1177/1941874414528940. PMC 4212414. PMID 25360204.

[pmid20610819-4] 4.0 ^4.1 ^4.2 ^4.3 ^4.4 ^4.5 Brouwer MC, Tunkel AR, van de Beek D (2010). "Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis". Clin Microbiol Rev. 23 (3): 467–92. doi:10.1128/CMR.00070-09. PMC 2901656. PMID 20610819.

[pmid18406976-5] 5.0 ^5.1 ^5.2 Mace SE (2008). "Acute bacterial meningitis". Emerg Med Clin North Am. 26 (2): 281–317, viii. doi:10.1016/j.emc.2008.02.002. PMID 18406976.

[abc-6] 6.0 ^6.1 ^6.2 ^6.3 ^6.4 https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017

[pmid21612470-7] 7.0 ^7.1 Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL; et al. (2011). "Bacterial meningitis in the United States, 1998-2007". N Engl J Med. 364 (21): 2016–25. doi:10.1056/NEJMoa1005384. PMID 21612470.

[pmid16231527-8] Wang HS, Kuo MF, Huang SC (2005). "Diagnostic approach to recurrent bacterial meningitis in children". Chang Gung Med J. 28 (7): 441–52. PMID 16231527.

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[3]

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@@ Line 4: / Line 4: @@
 ==Overview==
+There is no specific classification system for bacterial meningitis. However, it may be classified according to the age group, causative agent, clinical presentation, severity and duration of illness. Prognosis of bacterial meningitis may depend on the severity of the disease and causative agent.<ref name="pmid8750806">{{cite journal| author=Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N| title=Recurrent bacterial meningitis. | journal=Eur J Pediatr | year= 1996 | volume= 155 | issue= 1 | pages= 26-30 | pmid=8750806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8750806  }} </ref><ref name="pmid15469610">{{cite journal| author=Boos C, Daneshvar C, Hinton A, Dawes M| title=An unusual case of chronic meningitis. | journal=BMC Fam Pract | year= 2004 | volume= 5 | issue=  | pages= 21 | pmid=15469610 | doi=10.1186/1471-2296-5-21 | pmc=524513 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15469610  }} </ref><ref name="pmid25360204">{{cite journal| author=Baldwin KJ, Zunt JR| title=Evaluation and treatment of chronic meningitis. | journal=Neurohospitalist | year= 2014 | volume= 4 | issue= 4 | pages= 185-95 | pmid=25360204 | doi=10.1177/1941874414528940 | pmc=4212414 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25360204  }} </ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref><ref name="pmid18406976">{{cite journal| author=Mace SE| title=Acute bacterial meningitis. | journal=Emerg Med Clin North Am | year= 2008 | volume= 26 | issue= 2 | pages= 281-317, viii | pmid=18406976 | doi=10.1016/j.emc.2008.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18406976  }} </ref><ref name=abc>https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017</ref><ref name="pmid21612470">{{cite journal| author=Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL et al.| title=Bacterial meningitis in the United States, 1998-2007. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 21 | pages= 2016-25 | pmid=21612470 | doi=10.1056/NEJMoa1005384 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21612470  }} </ref>
 ==Classification==
-Bacterial meningitis may be classified according to the age group, causative agent, severity, and duration of disease.
+Bacterial meningitis may be classified according to the age group, causative agent, severity, and duration of disease.<ref name="pmid8750806">{{cite journal| author=Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N| title=Recurrent bacterial meningitis. | journal=Eur J Pediatr | year= 1996 | volume= 155 | issue= 1 | pages= 26-30 | pmid=8750806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8750806  }} </ref><ref name="pmid15469610">{{cite journal| author=Boos C, Daneshvar C, Hinton A, Dawes M| title=An unusual case of chronic meningitis. | journal=BMC Fam Pract | year= 2004 | volume= 5 | issue=  | pages= 21 | pmid=15469610 | doi=10.1186/1471-2296-5-21 | pmc=524513 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15469610  }} </ref><ref name="pmid25360204">{{cite journal| author=Baldwin KJ, Zunt JR| title=Evaluation and treatment of chronic meningitis. | journal=Neurohospitalist | year= 2014 | volume= 4 | issue= 4 | pages= 185-95 | pmid=25360204 | doi=10.1177/1941874414528940 | pmc=4212414 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25360204  }} </ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref><ref name="pmid18406976">{{cite journal| author=Mace SE| title=Acute bacterial meningitis. | journal=Emerg Med Clin North Am | year= 2008 | volume= 26 | issue= 2 | pages= 281-317, viii | pmid=18406976 | doi=10.1016/j.emc.2008.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18406976  }} </ref><ref name=abc>https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017</ref><ref name="pmid21612470">{{cite journal| author=Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL et al.| title=Bacterial meningitis in the United States, 1998-2007. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 21 | pages= 2016-25 | pmid=21612470 | doi=10.1056/NEJMoa1005384 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21612470  }} </ref>
-===According to age group===
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
-'''Meningitis in infants and newborns'''<br>
+| colspan="3" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''According to age group'''}}
-'''Meningitis in adults'''
+|+
+! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| '''Age group'''}}
-===According to causative agent===
+! style="background: #4479BA; width: 150px;" | {{fontcolor|#FFF| '''Etiological agent'''}}
-===According to severity===
+! style="background: #4479BA; width: 350px;" | {{fontcolor|#FFF| '''Clinical features'''}}
-'''Mild'''<br>
+|-
-'''Moderate'''<br>
+| style="padding: 5px 5px; background: #DCDCDC;" | Neonates and infants<ref name=abc>https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017</ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref>
-'''Severe or fatal'''
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Group B streptococcus
-===According to duration of disease===
+*[[Escherichia coli|E coli]]
-'''Acute'''
+*Listeria monocytogenes
-'''Subacute'''
+*Streptococcus pneumoniae
-'''Chronic'''
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Hypothermia]] or [[hyperthermia]]
+* [[Jaundice]]
+* [[Irritability]]
+* Bulging fontanelle
+* Vomiting
+* High pitched cry
+|
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Adults<ref name=abc>https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017</ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*[[Streptococcus pneumoniae]]
+*[[Neisseria meningitidis]]
+*[[Haemophilus influenzae|Hemophilus influenza type b]]
+*[[Listeria monocytogenes]]
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* [[Fever]]
+* [[Neck stiffness]]
+* [[Headache]]
+* [[Nausea and vomiting|Nausea and Vomiting]]
+* [[Papilledema]]
+* [[Bradycardia]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Elderly<ref name=abc>https://www.cdc.gov/meningitis/bacterial.html Accessed on 4th Jan, 2017</ref><ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Streptococcus pneumoniae
+*Listeria monocytogenes
+*Neisseria meningitides
+*Hemophilus influenza type b
+| style="padding: 5px 5px; background: #F5F5F5;" |
+* Hypothermia or hyperthermia
+* Altered mental status
+* Decreased oral intake
+* Disrupted sleep
+* Neck stiffness
+|-
+| colspan="3" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''According to severity of the disease'''}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Mild
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+*Early diagnosis and treatment
+*Responds to medical treatment
+*Typical clinical presentation
+*[[Immunocompetent]]
+*Good [[prognosis]]
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Moderate
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+*May present late with typical or atypical symptoms
+*May present with complications
+*Variable response to treatment
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Severe
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+*Presents with complications or prolonged illness
+*[[Immunocompromised]]
+*Common in extremes of age
+*Delayed diagnosis and treatment
+*Surgical treatment may be required in addition to medical treatment
+*Increased [[morbidity]] and [[mortality]]
+|-
+| colspan="3" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|'''According to the duration of disease'''}}
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Acute<ref name="pmid20610819">{{cite journal| author=Brouwer MC, Tunkel AR, van de Beek D| title=Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. | journal=Clin Microbiol Rev | year= 2010 | volume= 23 | issue= 3 | pages= 467-92 | pmid=20610819 | doi=10.1128/CMR.00070-09 | pmc=2901656 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20610819  }} </ref><ref name="pmid18406976">{{cite journal| author=Mace SE| title=Acute bacterial meningitis. | journal=Emerg Med Clin North Am | year= 2008 | volume= 26 | issue= 2 | pages= 281-317, viii | pmid=18406976 | doi=10.1016/j.emc.2008.02.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18406976  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+* Lasts less than 4 weeks
+* Patient acutely ill
+* Seeks medical treatment early due to sudden deterioration
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Chronic <ref name="pmid15469610">{{cite journal| author=Boos C, Daneshvar C, Hinton A, Dawes M| title=An unusual case of chronic meningitis. | journal=BMC Fam Pract | year= 2004 | volume= 5 | issue=  | pages= 21 | pmid=15469610 | doi=10.1186/1471-2296-5-21 | pmc=524513 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15469610  }} </ref><ref name="pmid25360204">{{cite journal| author=Baldwin KJ, Zunt JR| title=Evaluation and treatment of chronic meningitis. | journal=Neurohospitalist | year= 2014 | volume= 4 | issue= 4 | pages= 185-95 | pmid=25360204 | doi=10.1177/1941874414528940 | pmc=4212414 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25360204  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+* Lasts more than 4 weeks
+* Gradual deterioration of patient
+* Prolonged history of atypical symptoms
+* Common in older patients
+|-
+| style="padding: 5px 5px; background: #DCDCDC;" |Recurrent<ref name="pmid8750806">{{cite journal| author=Lieb G, Krauss J, Collmann H, Schrod L, Sörensen N| title=Recurrent bacterial meningitis. | journal=Eur J Pediatr | year= 1996 | volume= 155 | issue= 1 | pages= 26-30 | pmid=8750806 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8750806  }} </ref><ref name="pmid16231527">{{cite journal| author=Wang HS, Kuo MF, Huang SC| title=Diagnostic approach to recurrent bacterial meningitis in children. | journal=Chang Gung Med J | year= 2005 | volume= 28 | issue= 7 | pages= 441-52 | pmid=16231527 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16231527  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" colspan="2" |
+* Multiple episodes which lasts less than 4 weeks
+* History of incompliance to medication
+* Common in young children
+* Anatomical defect or [[immunosuppression]] may be the underlying cause
+|-
+|}
 ==References==
@@ Line 27: / Line 111: @@
 {{WikiDoc Help Menu}}
 {{WikiDoc Sources}}
+[[Category:Disease]]
+[[Category:Up-To-Date]]
+[[Category:Neurology]]
+[[Category:Emergency medicine]]
+[[Category:Infectious disease]]

Bacterial meningitis classification: Difference between revisions

Latest revision as of 20:34, 29 July 2020

Overview

Classification

References

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