Bacterial meningitis is still an important cause of mortality and morbidity despite advances in antimicrobial therapy and intensive care. A key factor preventing an introduction of more efficient therapeutical strategies is our incomplete understanding of the disease pathogenesis. In this article new mechanisms playing a role in the development of bacterial meningitis and the importance of immune responses are described. Current guidelines in the treatment of bacterial meningitis as well as some experimental approaches to immunomodulation of the disease are presented here.

        Key words: bacterial meningitis, hematoencephalic barrier, cerebral oedema, cephalosporins of the 3rd generation, corticosteroids