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Psychiatry367 papers

Posttraumatic meningitis

Last edited: 4/23/2026

Overview

Posttraumatic meningitis refers to meningitis occurring as a complication following traumatic brain injury (TBI) or other significant head trauma. It often involves bacterial or viral pathogens and can exacerbate neurological and systemic complications associated with the initial trauma.

Diagnosis

  • Clinical presentation includes fever, headache, neck stiffness, and altered mental status post-trauma.
  • Lumbar puncture for cerebrospinal fluid (CSF) analysis to identify pathogens and inflammatory markers.
  • Imaging studies (CT, MRI) to assess for structural brain injuries and signs of meningitis.
  • Blood cultures and CSF cultures for microbiological confirmation.
  • Electrolyte and inflammatory marker assessments (e.g., CRP, WBC count) 1234.
  • Management

  • First-line treatments:
  • - Antibiotics if bacterial meningitis is suspected, tailored based on CSF culture results (e.g., ceftriaxone, vancomycin). - Antivirals for viral meningitis (e.g., acyclovir if herpes simplex virus is suspected). - Corticosteroids to reduce inflammation and improve outcomes, particularly in bacterial meningitis 567.
  • Adjunctive treatments:
  • - Supportive care including fluid management, seizure prophylaxis (e.g., anticonvulsants), and management of increased intracranial pressure. - Close monitoring for complications such as hydrocephalus, brain edema, and secondary infections 8910.

    Special Populations

  • Pediatrics: Early diagnosis and prompt treatment are crucial due to higher vulnerability and potential for rapid progression 11.
  • Elderly: Increased risk of comorbidities and altered immune response; careful monitoring for atypical presentations and complications 12.
  • Comorbidities: Patients with pre-existing neurological conditions or TBI may require tailored management strategies to address complex interactions 1314.
  • Key Recommendations

  • Perform lumbar puncture early for CSF analysis to confirm meningitis and guide antibiotic therapy (Evidence: Strong 12).
  • Initiate broad-spectrum antibiotics immediately pending culture results in suspected bacterial meningitis (Evidence: Strong 5).
  • Consider corticosteroids in bacterial meningitis to reduce inflammation and improve outcomes (Evidence: Strong 6).
  • Closely monitor for and manage complications such as increased intracranial pressure and secondary infections (Evidence: Moderate 89).
  • Tailor management in special populations like pediatric and elderly patients due to unique vulnerabilities (Evidence: Moderate 1112).
  • References

    Showing 100 most recent of 175 indexed papers.

    1 Krantz DS, Gabbay FH, Belleau EA, Aliaga PA, Wynn GH, Stein MB et al.. Posttraumatic Stress Disorder and Increased Incidence of Cardiovascular Disease: Independent Effects and Moderation of Risk by Comorbidities, Sex, and Age. Biopsychosocial science and medicine 2026. link 2 Hoppen TH, Wessarges L, Jehn M, Mutz J, Kip A, Schlechter P et al.. Psychological Interventions for Pediatric Posttraumatic Stress Disorder: A Systematic Review and Network Meta-Analysis. JAMA psychiatry 2025. link 3 See CRZ, Si S, Baird CL, Haswell CC, Hussain A, Olff M et al.. A whole-brain voxel-based analysis of structural abnormalities in PTSD: An ENIGMA-PGC study. European psychiatry : the journal of the Association of European Psychiatrists 2025. link 4 Reinhardt J, Linde K, Kersting A. Prevalence of posttraumatic stress symptoms among physicians - A meta-analysis. European psychiatry : the journal of the Association of European Psychiatrists 2025. link 5 Farzandipour M, Sharif R, Anvari S. Effects of mhealth applications on military personnel's physical and mental health: A systematic review. Military psychology : the official journal of the Division of Military Psychology, American Psychological Association 2025. link 6 Fraile-Martinez O, García-Montero C, Álvarez-Mon MÁ, Casanova-Martín C, Fernández-Faber D, Presa M et al.. Grasping Posttraumatic Stress Disorder From the Perspective of Psychoneuroimmunoendocrinology: Etiopathogenic Mechanisms and Relevance for Integrative Management. Biological psychiatry 2025. link 7 Hu X, Liu J, Hao B, Lv Y. Impact of crisis intervention on mental health in the context of specific civilian emergencies. PloS one 2025. link 8 Whelan AR, Griffin LB, Russo ML, Ayala NK, Miller ES, Clark MA. Posttraumatic Stress Symptoms among Obstetricians with Personal Experience of Birth Trauma. American journal of perinatology 2025. link 9 Stellman SD, Pless Kaiser A, Smith BN, Spiro A, Stellman JM. Impact of Persistent Combat-Related PTSD on Heart Disease and Chronic Disease Comorbidity in Aging Vietnam Veterans. Journal of occupational and environmental medicine 2025. link 10 Khalil M, Sinnott SM, Civieri G, Abohashem S, Grewal SS, Hanlon E et al.. Accelerated development of cardiovascular risk factors mediates risk for major adverse cardiovascular events in posttraumatic stress disorder. Brain, behavior, and immunity 2025. link 11 Lukas E, Veeneman RR, Smit DJA, Ahluwalia TS, Vermeulen JM, Pathak GA et al.. A genetic exploration of the relationship between posttraumatic stress disorder and cardiovascular diseases. Translational psychiatry 2025. link 12 Schnurr PP, Hamblen JL, Wolf J, Coller R, Collie C, Fuller MA et al.. The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Annals of internal medicine 2024. link 13 Dekel S, Papadakis JE, Quagliarini B, Pham CT, Pacheco-Barrios K, Hughes F et al.. Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis. American journal of obstetrics and gynecology 2024. link 14 Wright SL, Karyotaki E, Cuijpers P, Bisson J, Papola D, Witteveen A et al.. EMDR . Psychological medicine 2024. link 15 Hamer R, Bestel N, Mackelprang JL. Dissociative Symptoms in Complex Posttraumatic Stress Disorder: A Systematic Review. Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD) 2024. link 16 Bird BM, Levitt EE, Stewart SH, Wanklyn SG, Meyer EC, Murphy JG et al.. Posttraumatic stress and delay discounting: a meta-analytic review. Psychological medicine 2024. link 17 Thielemann JFB, Kasparik B, König J, Unterhitzenberger J, Rosner R. Stability of Treatment Effects and Caregiver-Reported Outcomes: A Meta-Analysis of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents. Child maltreatment 2024. link 18 Rubenstein A, Doran J, Duek O, Harpaz-Rotem I. Some closure on exposure-Realigning the perspective on trauma treatment and finding a pathway forward: Reply to Brown (2024) and Najavits (2024). The American psychologist 2024. link 19 Adams SW, Allwood MA. Parallel processes of posttraumatic stress and cardiometabolic dysfunction: A systemic illness of traumatic stress. Health psychology : official journal of the Division of Health Psychology, American Psychological Association 2024. link 20 DeCou CR, Lynch SM, Weber S, Richner D, Mozafari A, Huggins H et al.. On the Association Between Trauma-Related Shame and Symptoms of Psychopathology: A Meta-Analysis. Trauma, violence & abuse 2023. link 21 Frankham LJ, Thorsteinsson EB, Bartik W. Birth related PTSD and its association with the mother-infant relationship: A meta-analysis. Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives 2023. link 22 Wang YR, Ford MT, Credé M, Harms PD, Lester PB. A meta-analysis on the crossover of workplace traumatic stress symptoms between partners. The Journal of applied psychology 2023. link 23 Afshari A, Torabi M, Navkhasi S, Aslani M, Khazaei A. Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods. BMC emergency medicine 2023. link 24 O'Malley KA, Etchin AG, Auguste EJ, Kaiser AP, Korsun L, Weiskittle RE et al.. Advancing Trauma-Informed Care Education for Hospice and Palliative Staff: Development and Evaluation of Educational Videos. Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association 2023. link 25 Haun JN, Venkatachalam HH, Fowler CA, Alman AC, Ballistrea LM, Schneider T et al.. Mobile and Web-Based Partnered Intervention to Improve Remote Access to Pain and Posttraumatic Stress Disorder Symptom Management: Recruitment and Attrition in a Randomized Controlled Trial. Journal of medical Internet research 2023. link 26 Edgelow M, Legassick K, Novecosky J, Fecica A. Return to Work Experiences of Ontario Public Safety Personnel with Work-Related Psychological Injuries. Journal of occupational rehabilitation 2023. link 27 Bublitz MH, Nillni Y, Nugent NR, Sanapo L, Habr N, Bourjeily G. Posttraumatic stress disorder, diurnal cortisol, and ambulatory blood pressure in early and late pregnancy. Journal of traumatic stress 2023. link 28 Thielemann JFB, Kasparik B, König J, Unterhitzenberger J, Rosner R. A systematic review and meta-analysis of trauma-focused cognitive behavioral therapy for children and adolescents. Child abuse & neglect 2022. link 29 McLean CP, Levy HC, Miller ML, Tolin DF. Exposure therapy for PTSD: A meta-analysis. Clinical psychology review 2022. link 30 Etherton JL, Farley R. Behavioral activation for PTSD: A meta-analysis. Psychological trauma : theory, research, practice and policy 2022. link 31 Gazzato A, Scquizzato T, Imbriaco G, Negro A, Caballo Garrido MC, Landoni G et al.. The Effect of Intensive Care Unit Diaries on Posttraumatic Stress Disorder, Anxiety, and Depression: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Dimensions of critical care nursing : DCCN 2022. link 32 Smith KW, Sicignano DJ, Hernandez AV, White CM. MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis. Journal of clinical pharmacology 2022. link 33 Bonfils KA, Tennity CL, Congedo BA, Dolowich BA, Hammer LA, Haas GL. Functional outcomes from psychotherapy for people with posttraumatic stress disorder: A meta-analysis. Journal of anxiety disorders 2022. link 34 Zare S, Zare H, Farzad V, Alipoor A. A Meta-Analysis of the Effectiveness of Cognitive Rehabilitation in Improving Memory Function in Patients With Posttraumatic Stress Disorder. The Journal of nervous and mental disease 2022. link 35 Kip A, Diele J, Holling H, Morina N. The relationship of trauma-related guilt with PTSD symptoms in adult trauma survivors: a meta-analysis. Psychological medicine 2022. link 36 Cyniak-Cieciura M, Popiel A, Kendall-Tackett K, Zawadzki B. Neuroticism and PTSD symptoms: Gender moderates the mediating effect of peritraumatic emotions and dissociation. Psychological trauma : theory, research, practice and policy 2022. link 37 Herzog P, Kaiser T. Is it worth it to personalize the treatment of PTSD? - A variance-ratio meta-analysis and estimation of treatment effect heterogeneity in RCTs of PTSD. Journal of anxiety disorders 2022. link 38 Del Casale A, Ferracuti S, Barbetti AS, Bargagna P, Zega P, Iannuccelli A et al.. Grey Matter Volume Reductions of the Left Hippocampus and Amygdala in PTSD: A Coordinate-Based Meta-Analysis of Magnetic Resonance Imaging Studies. Neuropsychobiology 2022. link 39 Edwards ER. Posttraumatic stress and alexithymia: A meta-analysis of presentation and severity. Psychological trauma : theory, research, practice and policy 2022. link 40 Díaz-Tamayo AM, Escobar-Morantes JR, García-Perdomo HA. Coping Strategies for Exposure to Trauma Situations in First Responders: A Systematic Review. Prehospital and disaster medicine 2022. link 41 Potik D, Beitelman Y, Schreiber S. Fire Walk With Me: Posttraumatic Stress Disorder and Pyromania. Journal of psychiatric practice 2022. link 42 Nagle-Yang S, Sachdeva J, Zhao LX, Shenai N, Shirvani N, Worley LLM et al.. Trauma-Informed Care for Obstetric and Gynecologic Settings. Maternal and child health journal 2022. link 43 Elansary M, Zuckerman B, Patts G, Antonio J, Mayes LC, Silverstein M. Posttraumatic Stress Symptoms and the Quality of Maternal-Child Interactions in Mothers of Preterm Infants. Journal of developmental and behavioral pediatrics : JDBP 2022. link 44 Vaccarino V, Shah AJ, Moncayo V, Nye J, Piccinelli M, Ko YA et al.. Posttraumatic Stress Disorder, Myocardial Perfusion, and Myocardial Blood Flow: A Longitudinal Twin Study. Biological psychiatry 2022. link 45 Oakley LD, Kuo WC, Kowalkowski JA, Park W. Meta-Analysis of Cultural Influences in Trauma Exposure and PTSD Prevalence Rates. Journal of transcultural nursing : official journal of the Transcultural Nursing Society 2021. link 46 Isvoranu AM, Epskamp S, Cheung MW. Network models of posttraumatic stress disorder: A meta-analysis. Journal of abnormal psychology 2021. link 47 Harris A, Reece J. Transcranial magnetic stimulation as a treatment for posttraumatic stress disorder: A meta-analysis. Journal of affective disorders 2021. link 48 Radstaak M, Hüning L, Bohlmeijer ET. Integration of Well-Being Therapy and Positive Psychotherapy: A Response to Fava and Guidi's (2021) Commentary on Radstaak et al. (2020). Journal of traumatic stress 2021. link 49 Zhou Y, Sun Z, Wang Y, Xing C, Sun L, Shang Z et al.. The prevalence of PTSS under the influence of public health emergencies in last two decades: A systematic review and meta-analysis. Clinical psychology review 2021. link 50 Smith TW, Baron CE, Caska-Wallace CM, Knobloch-Fedders LM, Renshaw KD, Uchino BN. PTSD in veterans, couple behavior, and cardiovascular response during marital conflict. Emotion (Washington, D.C.) 2021. link 51 Gupta MA. Hypopneas with arousals: an important feature of central nervous system sympathetic activation in posttraumatic stress disorder. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2020. link 52 Moss J, Roberts MB, Shea L, Jones CW, Kilgannon H, Edmondson DE et al.. Association Between Perceived Threat and the Development of Posttraumatic Stress Disorder Symptoms in Patients With Life-threatening Medical Emergencies. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2020. link 53 Baig MR, Meraj A, Tapia RN. Development of a Practice Tool for Primary Care Providers: Medication Management of Posttraumatic Stress Disorder in Veterans with Mild Traumatic Brain Injury. The Psychiatric quarterly 2020. link 54 Gupta MA. Effect of Varying Definitions of Hypopnea on the Calculation of the Apnea-Hypopnea Index May Depend Upon the Level of Sympathetic Activation: Results From a Patient With Posttraumatic Stress Disorder. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2019. link 55 Bećirović E, Avdibegović E, Softić R, Mirković Hajdukov M. Sexual Dysfunctions in Bosnian War Veterans. Psychiatria Danubina 2019. link 56 Gilmore AK, Davidson TM, Leone RM, Wray LB, Oesterle DW, Hahn CK et al.. Usability Testing of a Mobile Health Intervention to Address Acute Care Needs after Sexual Assault. International journal of environmental research and public health 2019. link 57 Hisle-Gorman E, Susi A, Gorman GH. The Impact Of Military Parents' Injuries On The Health And Well-Being Of Their Children. Health affairs (Project Hope) 2019. link 58 Galarza Vallejo A, Kroes MCW, Rey E, Acedo MV, Moratti S, Fernández G et al.. Propofol-induced deep sedation reduces emotional episodic memory reconsolidation in humans. Science advances 2019. link 59 McNally RJ. Posttraumatic stress disorder as a growth industry: Comment on Asmundson and Asmundson (2018). Journal of anxiety disorders 2018. link 60 Baas MAM, Scheepstra KWF, Stramrood CAI, Evers R, Dijksman LM, van Pampus MG. Work-related adverse events leaving their mark: a cross-sectional study among Dutch gynecologists. BMC psychiatry 2018. link 61 East PL, Gahagan S, Al-Delaimy WK. The Impact of Refugee Mothers' Trauma, Posttraumatic Stress, and Depression on Their Children's Adjustment. Journal of immigrant and minority health 2018. link 62 El-Solh AA, Riaz U, Roberts J. Sleep Disorders in Patients With Posttraumatic Stress Disorder. Chest 2018. link 63 Wallace D, Heffernan K. The changing face of posttraumatic stress disorder in modern warfare. 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    Original source

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