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Diagnosis is based on clinical and microbiological findings with neuroimaging in the form of CT reserved for those with specific adverse clinical features or when an underlying cause such as mastoiditis is suspected. MRI is extremely useful for detecting and monitoring the complications of meningitis. These can be remembered by the mnemonic HACTIVE (hydrocephalus, abscess, cerebritis\/cranial nerve lesion, thrombosis, infarct, ventriculitis\/vasculopathy and extra-axial collection). Diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) are useful to distinguish abscess from other ring enhancing lesions.<\/jats:p>","DOI":"10.1136\/pgmj.2010.097022","type":"journal-article","created":{"date-parts":[[2010,8,13]],"date-time":"2010-08-13T14:33:36Z","timestamp":1281710016000},"page":"478-485","source":"Crossref","is-referenced-by-count":84,"title":["Role of imaging in the diagnosis of acute bacterial meningitis and its complications"],"prefix":"10.1093","volume":"86","author":[{"given":"D C","family":"Hughes","sequence":"first","affiliation":[{"name":"Department of Radiology, Royal Hallamshire Hospital , Sheffield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Raghavan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sheffield Children\u2019s Hospital , Western Bank, Sheffield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S R","family":"Mordekar","sequence":"additional","affiliation":[{"name":"Ryegate Children\u2019s Centre, Tapton Crescent , Sheffield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P D","family":"Griffiths","sequence":"additional","affiliation":[{"name":"Academic Unit of Radiology, Royal Hallamshire Hospital , Sheffield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D J A","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sheffield Children\u2019s Hospital , Western Bank, Sheffield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,8,13]]},"reference":[{"key":"2023041909013774300_b1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S1473-3099(07)70050-6","article-title":"Emergency diagnosis and treatment of adult meningitis","volume":"7","author":"Fitch","year":"2007","journal-title":"Lancet Infect Dis"},{"key":"2023041909013774300_b2","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/j.1468-1331.2008.02193.x","article-title":"EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults","volume":"15","author":"Chaudhuria","year":"2008","journal-title":"Eur J Neurol"},{"key":"2023041909013774300_b3","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1016\/S0140-6736(03)13693-8","article-title":"Bacterial meningitis in children","volume":"361","author":"S\u00e1ez-Llorens","year":"2003","journal-title":"Lancet"},{"key":"2023041909013774300_b4","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1136\/bmj.306.6883.953","article-title":"Cerebral herniation during bacterial meningitis in children","volume":"306","author":"Rennick","year":"1993","journal-title":"Br Med J"},{"key":"2023041909013774300_b5","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/j.1440-1673.2005.01450.x","article-title":"Diagnostic imaging clinical effectiveness fact sheet: suspected meningitis-role of lumbar puncture and computed tomography","volume":"49","author":"de Campo","year":"2005","journal-title":"Australas Radiol"},{"key":"2023041909013774300_b6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1177\/0885066607299516","article-title":"Lumbar puncture and brain herniation in acute bacterial meningitis: a review","volume":"22","author":"Joffe","year":"2007","journal-title":"J Intensive Care Med"},{"key":"2023041909013774300_b7","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1056\/NEJMoa010399","article-title":"Computed tomography of the head before lumbar puncture in adults with suspected meningitis","volume":"345","author":"Hasbun","year":"2001","journal-title":"N Engl J Med"},{"key":"2023041909013774300_b8","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1056\/NEJM200204183461615","article-title":"Cranial CT before lumbar puncture in suspected meningitis","volume":"346","author":"Tattevin","year":"2002","journal-title":"N Eng J Med"},{"key":"2023041909013774300_b9","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.jinf.2008.09.033","article-title":"Antibiotic treatment delay and outcome in acute bacterial meningitis","volume":"57","author":"K\u00f8ster-Rasmussen","year":"2008","journal-title":"J Infect"},{"key":"2023041909013774300_b10","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0022-3476(87)80067-7","article-title":"Prospective study of computed tomography in acute bacterial meningitis","volume":"111","author":"Cabral","year":"1987","journal-title":"J. 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