Meningitis

Clinical Features
  • Headache
  • Fever
  • Altered consciousness
  • Neck stiffness
  • Nausea and vomiting
  • Rash
  • Seizures
  • Shock
Investigations

- Lumbar puncture:

  • Bacterial culture
  • Viral PCR
  • Cell counts / microscopy
  • Protein and glucose
  • Serum glucose (at the same time as LP)

- Blood culture

- Bacterial throat swab

- Viral throat swab

- Blood (EDTA) for meningococcal PCR

Infection Control

- Isolate

- Droplet precautions

- Fluid resistant surgical facemask for routine care and FFP3  mask for intubation or other procedures involving airway, until established on appropriate antimicrobial treatment.

Notes

Ceftriaxone is unrestricted for this indication

First Line Treatment

Ceftriaxone (IV) 2g 12 hourly

 If Listeria suspected: add

Amoxicillin (IV) 2g 4 hourly

Penicillin Allergy

Chloramphenicol (IV) 25 mg/kg 6 hourly

If Listeria suspected: add

Cotrimoxazole (IV) 1.44g 12 hourly

Duration

Review at 7 days, or when an organism is isolated