Suspected Bacterial Meningitis: Lumbar Puncture, Empiric Antibiotics, Steroids, Duration (WHO 2025)
Walks WHO 2025 suspected bacterial meningitis decisions: image first or defer the puncture, empiric antibiotics with Listeria and resistance add-ons, steroids and duration by setting, and contact prophylaxis.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age in years
- 30
- Setting
- Non-epidemic
- Cranial imaging readily accessible
- Yes
- GCS below 10
- No
- Focal neurological signs
- Yes
- Cranial nerve deficits
- No
- Papilledema
- No
- New-onset seizures
- No
- Severe immunocompromised state
- No
Result: Image the head before the lumbar puncture (focal neurological signs).
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Age in years
- Setting
- Cranial imaging readily accessible
- GCS below 10
- Focal neurological signs
- Cranial nerve deficits
- Papilledema
- New-onset seizures (adult)
- Severe immunocompromised state
The other 5 fields
- Other Listeria risk factor (pregnancy, immunosuppressive therapy, transplant, cancer, advanced HIV, diabetes, end-stage kidney disease, cirrhosis, alcohol)
- High local pneumococcal resistance
- Ceftriaxone or cefotaxime available
- Cerebral malaria suspected
- Advanced HIV disease
How this is calculated
Citation
WHO. WHO guidelines on meningitis diagnosis, treatment and care. Geneva: WHO; 2025. Executive summary: cranial imaging, empiric treatment, duration, prophylaxis and corticosteroids (pp. xiii-xxi). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.