Hospital doctors - adults

Management of Suspected Bacterial Meningitis and Meningococcal Septicaemia in Immunocompetent Adults

Algorithm for Hospital Doctors: Third Edition, January 2016

This protocol is for doctors in Emergency Medicine, General Medicine, Infectious Diseases, Critical Care and Anaesthetics.

Despite recent reductions in meningitis and meningococcal sepsis in children the disease continues to have an impact in the adult population and has considerable mortality associated with it. A recent study in England and Wales showed an increase in the incidence of meningitis in adults between 2004 and 2011, with an increase of 3% per year in patients over 65 years of age. The mortality rate of community acquired bacterial meningitis is high, up to 30% in some cases.

Prompt recognition and treatment are essential as delays in recognising the disease and commencing appropriate treatment can have disastrous consequences, including amputation, hearing loss, severe mental impairment and death.

The need for a guideline has become increasingly important over the last decade. Similar guidelines have not been published since a consensus statement issued by the British Infection Society in 1999 and a subsequent management algorithm published and distributed by uxs in 2003.

An expert group of doctors including infection specialists, brain specialists, intensive care specialists, acute physicians, public health experts along with patient group representatives, including representatives from Meningitis Research Foundation, worked together to devise this new guideline.

The guidelines cover the management of adults with suspected and confirmed acute meningitis and meningococcal sepsis, from pre-hospital care to post-discharge support, including clinical features, investigations, treatment, follow-up and prevention. As previously the guidelines focus on bacterial meningitis and meningococcal sepsis but now also include a section on viral meningitis which is a major cause of meningitis in the UK.

It is our intention to update the algorithm on a regular basis to accommodate new evidence and new practices as they arise. 

The algorithm can be obtained as a poster (A2) or leaflet, available free of charge by using our online ordering facility or you can:

We hope that this algorithm will be of practical value in enabling early recognition and management of meningitis and meningococcal septicaemia, facilitating a better outcome for patients.

We are always pleased to receive feedback, which will be used to improve future updated versions of the resource.

Send feedback to our Medical Information Officer Claire Wright

Page last updated 05.04.16