Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management

Context

This guideline is for healthcare professionals (including paramedics) working in:

Bacterial meningitis is an inflammation of the membranes that surround the brain and the spinal cord, caused by bacterial infection. We use the term 'meningococcal disease' to mean illness caused by an invasive meningococcal infection (including bloodstream infection and meningitis).

The main bacteria that cause meningitis in adults, children and babies over 3 months old are Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae (pneumococcus). These 2 bacteria normally spread by person-to-person droplet transmission (for example, sneezing). Haemophilus influenzae type b used to be another common cause, but since vaccination started it is now rare. In babies under 3 months old, group B Streptococcus, Escherichia coli and other coliforms are common. Listeria monocytogenes is very rare, but occasionally causes meningitis in older people, very young children, and in people with other risk factors.

There are variations in clinical practice for bacterial meningitis and meningococcal disease, including in access to intensive care support for critically ill children and adults. There is also variation in follow-up and management for complications. This guideline aims to address these variations and promote effective, evidence-based care for people with bacterial meningitis and meningococcal disease.