Infection of the meninges 

Viral disease is self-limiting, bacterial can be fatal

Neonates: Streptococcus. B, E.coli

Adults: Strep. pneumoniae, N. meningitidis

Elderly: Listeria

Other: Viral infections and TB

Kernig’s Sign Positive: Thigh flexed at hip and knee to 90 degree, and subsequent 

knee extension is painful

Brudzinski Sign Positive: Hip and knee flexion on neck flexion

Fever, chills, headache, photophobia, neck stiffness, vomiting and changes in mental state. Non-blanching rash.

Imaging: CT or MRI brain

Other: Lumbar puncture, gram stain, PCR, and blood cultures 

Medical: IV ceftriaxone immediately in suspected cases

IV vancomycin and ampicillin in elderly and immunocompromised. 

4 days dexamethasone in pneumococcal meningitis alongside antibiotics 

If viral cause potential IV acyclovir should be given

Prevention: Meningococcal and Pneumococcal vaccine

Chemoprophylaxis (ciprofloxacin, rifampicin) in close contacts

Prognosis is dependent on early diagnosis and commencement of antibiotic therapy. There is increased risk of both mortality around 10% and morbidity of around 30%