Spontaneous gram-negative meningitis: Difference between revisions

Latest revision as of 16:27, 19 July 2023

Organism	First-line	Second-line	Duration
E. coli and other Enterobacteriaceae	third-generation cephalosporin	ampicillin, meropenem, aztreonam, TMP-SMX, or ciprofloxacin	21 days
Pseudomonas aeruginosa	cefipime or ceftazidime	meropenem, aztreonam, or ciprofloxacin
ESBL Gram-negative bacillus	meropenem	cefepime or a fluoroquinolone

@@ Line 5: / Line 5: @@
 * Most commonly caused by [[Escherichia coli]], [[Klebsiella pneumoniae]], [[Pseudomonas aeruginosa]], and [[Acinetobacter]]
 * Also [[Citrobacter]], [[Serratia marcescens]], [[Enterobacter]], and [[Proteus mirabilis]]
+* Typically excludes usual causes of meningitis such as [[Haemophilus]] or [[Neisseria]]
-=== Risk Factosr ===
+=== Risk Factors ===
-* Diabetes mellitus
+* [[Diabetes mellitus]]
-* Cirrhosis
+* [[Cirrhosis]]
-* End-stage renal disease
+* [[End-stage renal disease]]
-* Substance abuse, including alcohol use disorder
+* [[Substance abuse]], including [[alcohol use disorder]]
-* Cancer
+* [[Cancer]]
+== Clinical Presentation ==
+* As per other forms of [[bacterial meningitis]]
+== Management ==
+* CNS dosed antibiotics to complete 21 days is typically sufficient
+{| class="wikitable sortable"
+!Organism
+!First-line
+!Second-line
+!Duration
+|-
+|''[[E. coli]]'' and other [[Enterobacteriaceae]]||third-generation cephalosporin||[[ampicillin]], [[meropenem]], [[aztreonam]], [[TMP-SMX]], or [[ciprofloxacin]]
+| rowspan="3" |21 days
+|-
+|''[[Pseudomonas aeruginosa]]''||[[cefipime]] or [[ceftazidime]]||[[meropenem]], [[aztreonam]], or [[ciprofloxacin]]
+|-
+|ESBL Gram-negative bacillus||[[meropenem]]||[[cefepime]] or a fluoroquinolone
+|}
 [[Category:CNS infections]]