Gram-negative meningitis is an infection of the membranes covering the brain and spinal cord (meninges) caused by bacteria that turn pink when exposed to a special stain (gram-negative bacteria).
Causes, incidence, and risk factors:
Acute bacterial meningitis can be caused by gram-negative bacteria. Bacteria causing gram-negative meningitis include:
- Acinetobacter baumannii
- Enterobacter aerogenes
- Escherichia coli
- Klebsiella pneumoniae
- Pseudomonas aeruginosa
Gram-negative meningitis is much more common in infants than adults.
Risk factors in adults and children include:
Signs and tests:
A physical examination may show:
For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap "), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing.
Antibiotic treatment through a vein (IV) usually starts right away. If you have a shunt, it may be removed to get rid of the infection.
It is important to recognize the symptoms of this meningitis, and seek treatment as soon as possible. Early treatment may prevent serious illness or death.
Many people recover completely, but a large number of people have permanent brain damage or die from this type of meningitis. Between 40% and 80% of patients with gram-negative meningitis do not survive, although these numbers may be improving. The likelihood of survival depends on:
- How quickly the infection is treated
- Other medical conditions that may be present
- The patient's age
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if you notice symptoms of meningitis. This condition can be very serious and needs immediate treatment.
Prompt treatment of related infections may reduce the risk of meningitis.
Swartz MN. Meningitis: bacterial, viral, and other. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 437.
|Review Date: 9/28/2008|
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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