Management algorithm for adults with suspected bacterial meningitis

CNS: central nervous system; CSF: cerebrospinal fluid; CT: computed tomography.
* Refer to UpToDate topic review on dexamethasone to prevent neurologic complications of bacterial meningitis in adults for specific recommendations.
¶ Refer to UpToDate table on recommendations for empiric antimicrobial therapy for purulent meningitis based on patient age and specific predisposing condition.
Δ Administer dexamethasone and antibiotic therapy immediately after CSF is obtained.
◊ Refer to UpToDate table on recommendations for antimicrobial therapy in adults with presumptive pathogen identification by positive Gram stain.
§ If the diagnosis of bacterial meningitis is likely.