[Meningitis and septic shock as acute, fatal conditions].

Meningitis and septic shock represent an acute inflammatory response in the subarachnoid space and the vascular tree respectively. Specific molecules in the bacterial outer membrane and exotoxins induce the inflammatory response through various mediator systems. The septic shock is caused by reduced vascular resistance and capillary leakage. Meningitis leads to altered brain metabolism, oedema and circulatory disturbance, which ultimately cause hypoxia. The general practitioner should be aware of the atypical symptomatology of meningitis in infants. Septic shock is related to meningococcal infections, pneumococcal infections in splenectomized persons and toxic shock syndromes. The authors give various advice concerning diagnosis, initial treatment and transport before admission to hospital.