What Is Gram-Negative Meningitis?
Gram-negative meningitis is an infection in the membrane
surrounding your brain and spinal cord.
“Gram-negative” refers to gram staining, a routine
laboratory test used to determine the presence of microorganisms like bacteria
or fungi in your blood or tissue. During the test, the gram stain will turn
pink if gram-negative bacteria are present. These types of bacteria can also
cause infections and pneumonia.
According to the Centers for
Disease Control and Prevention, gram-negative bacteria are resistant to
multiple antibiotic drugs commonly used to treat infection. In addition, they
have the capability to become resistant to new drugs. As a result, gram-negative
meningitis is harder to treat than other forms of meningitis. An estimated 40
to 80 percent of gram-negative meningitis cases end in death. Moreover,
complications are generally higher in survivors of gram-negative meningitis. It’s
more common in infants than adults.
What Are the Symptoms of Gram-Negative Meningitis?
Meningitis is often mistaken for the flu because both have
similar early signs. Additionally, both develop over a period of several hours
to a few days.
Symptoms of meningitis in newborns and infants include:
- bulge in the soft spot on the top of the head
- constant crying
- excessive irritability
- excessive sleepiness
- poor feeding
- stiffness in the body and neck
- fever, sweats, and/or chills
Symptoms of gram-negative meningitis in adults include:
- high fever, sweats, and/or chills
- lack of interest in eating or drinking
- sensitivity to light
- severe headache
- stiff neck
Risks of Catching Gram-Negative Meningitis
Gram-negative bacteria don’t reach the brain or spinal
column easily. Both of these parts of the body are generally well protected
from outside invaders. However, certain medical events increase your chances of
getting any kind of meningitis. Examples of these events include:
- brain surgery
- injury to the brain or head
- spinal abnormalities, such as spina bifida
- spinal fluid shunt after brain surgery, used to
- weakened immune system from cancer or AIDS
What Causes Gram-Negative Meningitis?
Gram-negative meningitis occurs when the membrane of your
brain and spinal cord becomes infected with a strain of gram-negative bacteria.
coli, or E. coli
How Is Gram-Negative Meningitis Diagnosed?
Your doctor will start with a physical exam and will look for
signs of a fast heart rate, fever, and stiff neck. They will do a thorough
neurological and skin examination. They will also check if you’ve experienced
confusion or disorientation.
If your doctor suspects meningitis, they will order a spinal
tap, also known as a lumbar puncture. During this procedure, a needle will be
used to extract cerebrospinal fluid, the clear liquid that cushions your brain
and spinal column. It is not uncommon to have a headache after this procedure.
The fluid is sent to a lab for testing. People with
meningitis often show increased levels of proteins and white blood cells in
their spinal fluid.
The fluid will also be tested with a gram stain test and a
bacterial culture. In addition to a positive or negative result, the test will
provide a description of the bacteria in the infection. This will help guide
Results can take up to a week, and in the meantime your
doctor may order other tests to help reach a definitive diagnosis.
Additional tests for meningitis include:
- blood culture
- CT scan
- polymerase chain reaction, PCR, amplification,
used to amplify DNA
How Do Doctors Treat Gram-Negative Meningitis?
As soon as meningitis is diagnosed or even suspected, you
will be admitted to the hospital and put on IV antibiotics. Most other types of
meningitis respond to common antibiotics. However, several different drugs must
be used to treat gram-negative meningitis since it is typically resistant to
normal antibiotics. Ceftazidime is one of the most common types, and other
antibiotics may be used as well.
If your infection was caused by a shunt after brain surgery,
the shunt may be removed to prevent further infection.
How Prevent Gram-Negative Meningitis?
Prevention aims to identify and treat the disease as quickly
as possible. Antibiotics are usually prescribed. Gram-negative meningitis is
the most difficult type of meningitis to treat. Even though there is a high
mortality rate, as high as 80
percent, a full recovery is possible. Recovery is dependent on:
- age: newborns, infants, and the elderly have the
- how quickly treatment begins
- complications from other conditions, such as
prevent getting an infection, practicing good hygiene habits like washing your
hands and covering your mouth when you cough will help stop the spread of
bacteria. Maintaining a strong and healthy immune system will also help your
body fight any potentially harmful bacteria.