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Gram-negative meningitis

Gram-negative meningitis

Meningitis is present when the membranes covering of the brain and spinal cord become swollen and inflamed. This covering is called the meninges.

Bacteria are one type of germ that may cause meningitis. Gram-negative bacteria are a type of bacteria that behave in a similar manner in the body. They are called gram-negative because they turn pink when tested in the laboratory with a special stain called Gram stain.

Images

Central nervous system and peripheral nervous system
CSF cell count

Causes

Acute bacterial meningitis can be caused by different Gram-negative bacteria including meningococcal and H influenzae.

This article covers Gram-negative meningitis caused by the following bacteria:

Gram-negative meningitis is more common in infants than adults. But it can also occur in adults, especially those with one or more risk factors. Risk factors in adults and children include:

Symptoms

Symptoms usually come on quickly, and may include:

Other symptoms that can occur with this disease:

Exams and Tests

The health care provider will perform a physical exam. Questions will focus on symptoms and possible exposure to someone who might have the same symptoms, such as a stiff neck and fever.

If the provider thinks meningitis is possible, a lumbar puncture (spinal tap) will likely be done to remove a sample of spinal fluid for testing.

Other tests that may be done include:

Treatment

Antibiotics will be started as soon as possible. Ceftriaxone, ceftazidime, and cefepime are the most commonly used antibiotics for this type of meningitis. Other antibiotics may be given, depending on the type of bacteria.

If you have a spinal shunt, it may be removed.

Outlook (Prognosis)

The earlier treatment is started, the better the outcome.

Many people recover completely. But, many people have permanent brain damage or die of this type of meningitis. Young children and adults over age 50 have the highest risk for death. How well you do depends on:

Possible Complications

Long-term complications may include:

When to Contact a Medical Professional

Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:

Meningitis can quickly become a life-threatening illness.

Prevention

Prompt treatment of related infections may reduce the severity and complications of meningitis.

Related Information

Meningitis
Head injury - first aid
Ventriculoperitoneal shunting
Urinary tract infection - adults
Shock
Brain abscess

References

Centers for Disease Control and Prevention website. Bacterial meningitis. www.cdc.gov/meningitis/bacterial.html. Updated August 6, 2019. Accessed December 1, 2020.

Nath A. Meningitis: bacterial, viral, and other. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 384.

Hasbun R,Van de Beek D, Brouwer MC, Tunkel AR.. Acute meningitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 87.

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Review Date: 10/25/2020  

Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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