Clinical guidelines for meningitis in low- and middle-income countries

Meningitis remains a significant public health concern. Patients typically present with fever and neurological symptoms such as headache, altered sensorium, or seizures. However, older adults and immunocompromised individuals often have atypical presentations, including absence of fever, warranting a low threshold for cerebrospinal fluid analysis and neuroimaging. While bacterial meningitis is the most common cause worldwide, tuberculous meningitis is the leading aetiology in endemic regions and frequently presents acutely. Early recognition and prompt empirical therapy, including antimicrobials and dexamethasone, are critical for improving outcomes.