From the Guidelines
Meningitis is a severe and potentially life-threatening inflammation of the protective membranes (meninges) that cover the brain and spinal cord, typically caused by infection, and requires immediate medical attention to prevent morbidity and mortality. The condition can be bacterial, viral, fungal, or parasitic in origin, with bacterial meningitis being the most severe form. According to the UK Joint Specialist Societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults 1, the clinical features of meningitis include fever, vomiting, headache, and neck stiffness, although these symptoms can be poor discriminators for meningitis when taken independently.
The diagnosis of meningitis involves analyzing cerebrospinal fluid obtained through lumbar puncture, along with blood tests and imaging studies. The ESCMID guideline on the diagnosis and treatment of acute bacterial meningitis 1 highlights the importance of prompt treatment with intravenous antibiotics, such as ceftriaxone, vancomycin, or ampicillin, with the specific regimen depending on the suspected pathogen and local resistance patterns.
Some key points to consider in the diagnosis and management of meningitis include:
- The "classic triad" of neck stiffness, fever, and altered consciousness is present in less than 50% of cases of bacterial meningitis 1
- Patients with pneumococcal disease are more likely to have seizures, focal neurological symptoms, and a reduced conscious level 1
- A rash is present in 92% of cases of Neisseria meningitidis infection, but 37% of cases of meningococcal meningitis do not have a rash 1
- Vaccination against common bacterial causes like Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis provides important protection against the disease 1
Prompt recognition and treatment of meningitis are crucial to preventing morbidity and mortality, and vaccination against common bacterial causes is an important preventive measure.
From the FDA Drug Label
MENINGITIS Caused by Haemophilus influenzae, Neisseria meningitidis or Streptococcus pneumoniae Ceftriaxone for Injection has also been used successfully in a limited number of cases of meningitis and shunt infection caused by Staphylococcus epidermidis1 and Escherichia coli.
Meningitis is an infection caused by susceptible organisms such as Haemophilus influenzae, Neisseria meningitidis, or Streptococcus pneumoniae. It can also be caused by other bacteria like Staphylococcus epidermidis and Escherichia coli in some cases 2.
- The drug label does not provide a detailed definition of meningitis, but it mentions the causative organisms.
- Key points about meningitis include its association with certain bacterial infections.
From the Research
Definition of Meningitis
Meningitis is a contagious bacterial infection caused by various pathogens, including Streptococcus pneumoniae and Neisseria meningitidis [(3,4,5)].
Causes of Meningitis
- Bacterial meningitis can be caused by Streptococcus pneumoniae, with some strains showing high resistance to cephalosporins [(3,4)]
- Neisseria meningitidis is another common cause of meningococcal disease 5
Treatment and Prevention
- The use of empiric vancomycin plus a third-generation cephalosporin for suspected bacterial meningitis has been recommended since 1997 3
- Combinations of ceftriaxone plus vancomycin, or vancomycin plus rifampicin, have been shown to be effective in the therapy of experimental pneumococcal meningitis 4
- Antibiotics such as ciprofloxacin, rifampin, minocycline, and penicillin have been found to be effective in eradicating N. meningitidis 5