Prognosis

Since the development of penicillins, mortality from bacterial meningitis has been reduced from 80% to 20% (5-30%). Nevertheless, it has not changed significantly since then: Although antibiotic therapy has improved, overall mortality has not decreased as the age of the patients has increased. Unfavorable factors for the prognosis of bacterial meningitis are After the acute symptoms have subsided, general impairments such as lack of concentration, irritability or dizziness may persist for several weeks or months.

In some cases, permanent damage (defect healing) can be caused by a too low dosage or too short duration of antibiotic therapy. In meningococcal meningitis with sepsis (blood poisoning), there is a risk of defect healing with intelligence-lowering dementia in over 50% of cases.

Rapid development of the clinical picture
Disturbances of consciousness within the first 24 hours
Duration of a coma
No or little pus formation, although bacteria are the cause (apurulent course): this indicates a weakened immune system
Higher age
Complications such as hydrocephalus (accumulation of cerebrospinal fluid), pus-filled brain ventricles (ventricle lymph) or vasculitis (inflammatory changes in blood vessels)
Hearing loss up to deafness due to damage to the sensitive auditory nerve (N. acusticus). Facial paralysis due to damage to the facial nerve (facial nerve paresis) or other cranial nerves can also occur.
Gluing and scarring of the meninges can lead to a disturbed drainage of the nerve water and thus to an increase in pressure inside the skull (hydrocephalus).
Pathogens remaining inside the skull can form an encapsulated abscess.
Epilepsy can also occur more frequently.

Rehabilitation

Rehabilitation can be carried out as an inpatient in a rehabilitation clinic or as an outpatient in a neurological therapy center. Early intervention in the case of recognizable defect healings or late damages is reasonable and depends on the remaining deficits, especially

Speech therapy
Hearing aids such as cochlear implants or hearing aids
Concentration training
Memory training in groups or computer-based
Occupational therapy to restore fine motor skills
Physiotherapy (physiotherapy) for balance disorders, dizziness and to promote mobility.