MANAGEMENT OF

BACTERIAL MENINGITIS
  Blood Tests should always be taken on admission and
are helpful when antibiotics are started before LP. Blood
cultures are positive in 50–80% of bacterial meningitis
cases

Blood Cultures  Procalcitonin & C-REACTIVE PROTEIN

 Computed tomography (CT) of the head is indicated in
the following conditions:
▪️ focal neurology

▪️ increased intracranial pressure (including

papilledema) deteriorating neurological function (such as
IMAGING increasing obtundation or seizures)
▪️ immunocompromise or history of neurosurgical
procedures
▪️ shunt or hydrocephalus
 LUMBAR
PUNCTURE
 LUMBAR
PUNCTURE
  Dexamethasone should be started either shortly before
or simultaneously with antibiotics at 0.15mg/kg
intravenously every 6-hours for 2-4 days
Corticosteroids  If pneumococcal meningitis is probable,
dexamethasone should continue for 4 days
  If a patient exhibits signs of airway, breathing or
circulatory difficulties (eg in coexisting sepsis),
management should initially focus on stabilisation of
these systems

Supportive Care  Mannitol

  Close contacts of all children with meningococcal
meningitis should receive chemoprophylaxis
(ceftriaxone, rifampicin, or ciprofloxacin), and
contacts of those with Hib should receive
ceftriaxone or rifampicin.
Chemoprophylaxis  Unvaccinated children less than 5 years of age
should also be vaccinated against H. influenzae as
soon as possible.
 Respiratory isolation for at least the first 24 hours
after commencing antibiotic therapy