Meningitis - gram-negative

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Central nervous system

Gram-negative meningitis

• Fever
• Severe headache
• Nausea and vomiting
• Stiff neck
• Sensitivity to light (photophobia)
• Mental status changes
• Symptoms suggesting infection of bladder, kidney, intestines, or lungs, which might be the source of the spinal fluid infection

For any patient with meningitis, it is important to perform a lumbar puncture (spinal tap). In a lumbar puncture, doctors take a sample of the patient's spinal fluid (known as cerebrospinal fluid, or CSF) for testing.

• Low blood pressure
• Fast heart rate
• Stiff neck
• Elevated white blood cell count in blood
• Spinal fluid showing increased white blood cells, low glucose, high protein
• Special stain of the spinal fluid showing white blood cells and sometimes gram-negative bacteria
• CSF culture growing gram-negative bacteria
• Blood culture growing gram-negative bacteria
• CT scan of the brain (usually normal)

Review Date: 09/06/2006
Reviewed By: Hilary M. Babcock, M.D., Medical Director of Occupational Infection Control, Barnes-Jewish and St. Louis Children's Hospitals; Instructor of Medicine, Infectious Disease Division, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.