Gram-negative meningitis is an infection of the membranes covering the brain and spinal cord (meninges) from 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.
Meningococcal and H. influenzae meningitis are due to Gram-negative bacteria and are covered in detail in other articles. This article covers bacteria causing Gram-negative meningitis due to the following common causes:
Gram-negative meningitis is more common in infants than adults, but is of growing importance in adults, especially those with one or more risk factors. Risk factors in adults and children include:
Antibiotics should be started as soon as possible. Ceftriaxone, ceftazidime, or cefepime are the most commonly used antibiotics for this type of meningitis. Other antibiotics may be used, depending on the type of bacteria.
If you have a spinal shunt, it may be removed.
The early treatment is started, the better the outcome.
Many people recover completely, but a large number of people have permanent brain damage or die from this type of meningitis. Young children and adults over age 50 have the highest risk of death. How well you do depends on:
Tunkel AR, Van de Beek D, Scheld WM. Acute meningitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 84.
Thigpen MC, Whitney CG, Messonnier NE, et al. Emerging Infections Programs Network. Bacterial meningitis in the United States, 1998-2007. N Engl J Med. 2011 May 26;364(21):2016-25.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.