Bacterial Meningitis

Bacterial meningitis is a serious infection causing inflammation of the membranes covering the brain and spinal cord, most often caused by Neisseria meningitidis, Streptococcus pneumoniae, or Haemophilus influenzae type b. It is a medical emergency requiring urgent treatment.

• Sudden onset of fever
• Severe headache
• Neck stiffness
• Sensitivity to light (photophobia)
• Vomiting
• Altered consciousness or confusion
• In infants: bulging fontanelle, poor feeding, and irritability
• A non-blanching rash may occur with meningococcal disease

• Caused by bacteria invading the meninges, often spreading from the nasopharynx or bloodstream.
• Risk is increased in young children, people living with HIV, and during outbreaks, particularly in the dry season.

• Lumbar puncture with cerebrospinal fluid (CSF) analysis — cell count, glucose, protein, Gram stain, and culture — is the key diagnostic test and should be performed urgently unless contraindicated.
• Blood cultures are also collected where feasible, without delaying the start of antibiotics.

Bacterial meningitis is a hospital-level emergency. Empirical treatment with intravenous ceftriaxone is started as soon as meningitis is suspected, without waiting for confirmatory test results.

Supportive care addresses fever, seizures, and raised intracranial pressure.

Treatment is adjusted once the causative organism and its antibiotic sensitivity are known.

Close contacts of a confirmed meningococcal meningitis case are offered chemoprophylaxis, such as ciprofloxacin, according to national outbreak protocols.

• Complete routine childhood immunisation, including Haemophilus influenzae type b and pneumococcal conjugate vaccines.
• Meningococcal vaccination during outbreaks or for identified high-risk groups.
• Prompt treatment of ear and sinus infections.
• Chemoprophylaxis for close contacts of confirmed cases.