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Internal Medicine

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A 24-year-old woman is admitted with suspected bacterial meningitis. She is treated empirically on admission with intravenous ceftriaxone and vancomycin. Cerebrospinal fluid culture obtained in the Emergency Department grows Neisseria meningitidis on hospital day two. The patient's doctor calls you. The patient has received ceftriaxone for 48 hours and is improving but has not been on any isolation precautions.

The doctor asks which of the following options would be most appropriate at this point.

  • 0%Continue standard precautions

  • 0%Place the patient on airborne isolation

  • 0%Place the patient on contact precautions

  • 0%Place the patient on contact precautions & airborne isolat


Neisseria meningitidis is transmitted person-to-person by respiratory particles, which travel about 3 feet before dropping from the air by the force of gravity or being diluted by the surrounding air. N. meningitidis is a common cause of bacterial meningitis, and therefore, patients with suspected bacterial meningitis are placed on droplet precautions -- personal mask when within 6 feet of the patient.

After 24 hours of effective antimicrobial therapy, patients with meningitis due to Neisseria meningitidis are no longer contagious and hence, in this case in which the patient had been treated for >24 hours, isolation precautions were no longer indicated. @Everyone

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