Central nervous system infections

Bacterial meningitis

See the NHSGGC poster and discuss duration of therapy with the microbiology / infectious disease unit (see Appendix 6 for contact details). If subacute presentation or risk factors, consider TB meningitis but discuss with infectious diseases team. For mycobacterial culture of CSF an additional 5-10ml is required.

If suspected CNS infection in an immunocompromised host, including HIV, discuss with the microbiology / infectious disease team.  

Meningitis Contact Prophylaxis

All suspected cases of meningococcal disease are notified to the NHSGGC Board, Public Health Protection Unit (see Appendix 6 for contact details). Specialists in Communicable Disease will identify close family and friends of the patient who may require antibiotic prophylaxis, which should be given as soon as possible (ideally within 24 hours) after diagnosis of the index case.

• Contact prophylaxis – oral therapy (whenever possible)
• Contact prophylaxis – when oral therapy not appropriate

Brain Abscess

• Perform blood cultures.
• Discuss treatment and duration with neurosurgery and microbiology / infectious diseases unit.
• Potential sources include: sinus, middle ear, post-traumatic, blood stream (endocarditis).

• Upper respiratory tract source (sinus and middle ear)
• Post-traumatic or blood stream source

Viral encephalitis

See the NHSGGC poster and discuss duration of therapy with the infectious disease team.

Guideline reviewed: August 2023

Page last updated: November 2023