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Meningitis caused by Bordetella pertussis

Last edited: 4/15/2026

Overview

Bordetella pertussis meningitis is a rare but serious complication of pertussis infection, primarily affecting unvaccinated individuals or those with waning immunity 1.

Diagnosis

  • Clinical presentation includes fever, headache, altered mental status, and signs of meningeal irritation 1.
  • Lumbar puncture essential for cerebrospinal fluid (CSF) analysis showing pleocytosis, elevated protein, and low glucose levels 1.
  • Polymerase chain reaction (PCR) of CSF can confirm B. pertussis presence 1.

    • Management

  • First-line treatment: Intravenous (IV) antibiotics such as ceftriaxone or ampicillin, typically initiated empirically before culture results 1.
  • Adjunctive therapy: Supportive care including hydration, anticonvulsants if seizures occur, and monitoring for complications like hydrocephalus 1.

    • Special Populations

  • Pregnancy: Limited data; management focuses on supportive care with close monitoring; antibiotic choice should consider fetal safety 1.
  • Pediatrics: Early recognition and prompt antibiotic therapy are crucial due to higher vulnerability 1.
  • Elderly: Increased vigilance for complications; supportive care measures are essential alongside antibiotic treatment 1.
  • Comorbidities: Patients with underlying conditions require tailored management focusing on mitigating exacerbation risks 1.

    • Key Recommendations

  • Initiate empirical IV antibiotic therapy promptly upon suspicion of B. pertussis meningitis 1 (Evidence: Strong).
  • Perform lumbar puncture and CSF analysis for definitive diagnosis 1 (Evidence: Strong).
  • Provide comprehensive supportive care including monitoring for neurological complications 1 (Evidence: Moderate).

    • References

    1 Shaw LB, Shaw RA. The Pre-Anschluss Vienna School of Medicine - The medical scientists: Karl Landsteiner (1868-1943) and Otto Loewi (1873-1961). Journal of medical biography 2016. link

    Original source

    1. [1]
      The Pre-Anschluss Vienna School of Medicine - The medical scientists: Karl Landsteiner (1868-1943) and Otto Loewi (1873-1961). — Shaw LB, Shaw RA Journal of medical biography (2016)
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