- Persisting fever: In patients with prolonged fever, a source must be sought. Causes of prolonged fever may range from drug fevers, recurrence of infection, or development of secondary infection, including brain abscess or subdural empyema. Resolution of fever is a key indicator of the clinical course for patients with meningitis. Approximately 75% of patients with S. pneumoniae or N. meningitides meningitis become afebrile by treatment day 4, and 90% are afebrile by day 6. Patients with H. influenzae type b meningitis remain febrile for a longer time, with only 75% afebrile by day 6 and only 90% by day 10.
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