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Clinical Features and Prognostic Factors in Adults with Bacterial Meningitis
NEJM 351:1849-1859,1826, van de Beek,D.,et al, 2004
See this aricle in Pubmed

Article Abstract
In adults presenting with community-acquired acute bacterial meningitis, the sensitivity of the classic triad of fever, neck stiffness, and altered mental status is low, but almost all present with a t least two of the four symptoms of headache, fever, neck stiffness, and altered mental status. The mortality associated with bacterial meningitis remains high, and the strongest risk factors for an unfavorable outcome are those that are indicative of systemic compromise, a low level of consciousness, and infection with S. pneumoniae.
 
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