Management of Suspected Bacterial Meningitis - Flowchart
Management of Suspected Bacterial Meningitis - Flowchart Management of Suspected Bacterial Meningitis Management of Suspected Bacterial Meningitis
Flowchart

Suspected bacterial meningitis
Two or more of:


Headache
Fever
Neck stiffness
Reduced conscious level

Suspected bacterial meningitis
Two or more of:


Headache
Fever
Neck stiffness
Reduced conscious level

Suspected bacterial meningitis
Two or more of:



Headache
Fever
Neck stiffness
Reduced conscious level


Headache
Fever
Neck stiffness
Reduced conscious level

End

End

End

Key observations (Table 1.1)
Stabilize airway, breathing and circulation
Focused assessment (Table 68.1)
Urgent investigation (Table 68.2)

Key observations (Table 1.1)
Stabilize airway, breathing and circulation
Focused assessment (Table 68.1)
Urgent investigation (Table 68.2)

Key observations (Table 1.1)
Stabilize airway, breathing and circulation
Focused assessment (Table 68.1)
Urgent investigation (Table 68.2)

Table 1.1

Table 68.1
Table 68.2

Do lumbar puncture

Do lumbar puncture

Do lumbar puncture

Continue antibiotic therapy
Seek advice from infectious diseases physician/neurologist
Supportive care

Continue antibiotic therapy
Seek advice from infectious diseases physician/neurologist
Supportive care

Continue antibiotic therapy
Seek advice from infectious diseases physician/neurologist
Supportive care



Antibiotic therapy (Table 68.3)
Consider dexamethasone (Table 68.4)
Seek advice from microbiologist
Supportive care

Antibiotic therapy (Table 68.3)
Consider dexamethasone (Table 68.4)
Seek advice from microbiologist
Supportive care

Antibiotic therapy (Table 68.3)
Consider dexamethasone (Table 68.4)
Seek advice from microbiologist
Supportive care

Table 68.3
Table 68.4

Pursue other diagnoses (Table 68.5 and 68.6)

Pursue other diagnoses (Table 68.5 and 68.6)

Pursue other diagnoses (Table 68.5 and 68.6)

Table 68.5 68.6

Shock?

Shock?

Shock?

Yes

Yes

Yes

No

No

No

Antibiotic therapy (Table 68.3)
Call resuscitation team
See chapter 35 for further management of septic shock

Antibiotic therapy (Table 68.3)
Call resuscitation team
See chapter 35 for further management of septic shock

Antibiotic therapy (Table 68.3)
Call resuscitation team
See chapter 35 for further management of septic shock

Table 68.3

chapter 35

Indications for CT scan before lumbar puncture (LP) (see text) or coagulopathy?

Indications for CT scan before lumbar puncture (LP) (see text) or coagulopathy?

Indications for CT scan before lumbar puncture (LP) (see text) or coagulopathy?

Yes

Yes

Yes

No

No

No

Cerebrospinal fluid consistent with bacterial meningitis? (Table 68.5)

Cerebrospinal fluid consistent with bacterial meningitis? (Table 68.5)

Cerebrospinal fluid consistent with bacterial meningitis? (Table 68.5)

Table 68.5

Yes

Yes

Yes

No

No

No

LP still contraindicated?

LP still contraindicated?

LP still contraindicated?

Yes

Yes

Yes

No

No

No