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Role of imaging in the diagnosis of acute bacterial meningitis and its complications
  1. D C Hughes1,
  2. A Raghavan2,
  3. S R Mordekar3,
  4. P D Griffiths4,
  5. D J A Connolly2
  1. 1Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK
  2. 2Department of Radiology, Sheffield Children's Hospital, Western Bank, Sheffield, UK
  3. 3Ryegate Children's Centre, Tapton Crescent, Sheffield, UK
  4. 4Academic Unit of Radiology, Royal Hallamshire Hospital, Sheffield, UK
  1. Correspondence to Dr David C Hughes, Department of Radiology, C Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK; dchughes{at}


Acute bacterial meningitis is a common neurological emergency and a leading cause of death and neurological disability worldwide. Diagnosis is based on clinical and microbiological findings with neuroimaging in the form of CT reserved for those with specific adverse clinical features or when an underlying cause such as mastoiditis is suspected. MRI is extremely useful for detecting and monitoring the complications of meningitis. These can be remembered by the mnemonic HACTIVE (hydrocephalus, abscess, cerebritis/cranial nerve lesion, thrombosis, infarct, ventriculitis/vasculopathy and extra-axial collection). Diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) are useful to distinguish abscess from other ring enhancing lesions.

  • Meningitis
  • MRI
  • diffusion weighted imaging
  • lumbar puncture
  • infectious diseases
  • paediatric neurology
  • neuroradiology
  • paediatric radiology

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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