Gram-negative meningitis is a bacterial infection of the membranes covering the brain and spinal cord (meninges). The bacteria turn pink when exposed to a special stain (Gram-negative bacteria).
Acute bacterial meningitis can be caused by Gram-negative bacteria.
Meningococcal and H. influenzae meningitis are caused by Gram-negative bacteria and are covered in detail in other articles. This article covers Gram-negative meningitis caused by the following bacteria:
Gram-negative meningitis is more common in infants than adults. But it is also important 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, and 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 earlier 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:
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;364:2016-2025.
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.
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, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.