Bacterial meningitis: management

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Bacterial meningitis: management. Take blood cultures, Perform lumbar puncture (LP). Fully referenced neurology checklist.

Management guidelines

  • Take blood cultures
  • Perform lumbar puncture (LP)
  • Administer antibiotics within 60 minutes
  • Administer Dexamethasone with or shortly before the 1st dose of antibiotic
  • Report all suspected meningococcal or Haemophilus influenza meningitis

Indications for head CT before lumbar puncture (LP)

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Antibiotic choice

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Duration of antibiotic treatment

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Contact prophylaxis: for meningococcal meningitis

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Vaccination

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Emerging investigations

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References

  1. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 2004; 39:1267-1284.
  2. Chaudhuri A, Martin PM, Kennedy PGE, et al. 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. Eur J Neurol 2008; 15: 649-659.
  3. Hasbun R, Abrahams J, Jekel J, Quagliarello VJ. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med 2001; 345:1727-1733.
  4. Glimåker M, Lindquist L, Sjölin J. Lumbar puncture in adult bacterial meningitis: time to reconsider guidelines? BMJ 2013; 346:f361.
  5. Carter E, McGill F. The management of acute meningitis: an update. Clin Med (Lond) 2022; 22:396-400.
  6. And 2 more. Subscribe to see the full list

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