Unusual posture, with the head and neck arched backwards (opisthotonos)
Signs and tests
A physical examination will usually show:
Fast heart rate
Mental status changes
For any patient who is suspected of having 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.
Treatment with antibiotics should be started as soon as possible. Ceftazidime or Cefepime is one of the most commonly used antibiotics for this type of meningitis, but other antibiotics may be used, depending on the type of bacteria.
If you have a shunt, it may be removed to get rid of the infection.
Early treatment improves the outcome. Between 40% and 80% of patients with Gram-negative meningitis do not survive. Young children and adults over age 50 have the highest risk of death.
Many people recover completely, but a large number of people have permanent brain damage or die from this type of meningitis. The likelihood of survival depends on:
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, 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., Inc.