E coli and group B streptococci account for the vast majority of cases of neonatal meningitis. E coli accounts for 28.5%, while group B streptococci account for 34.1%. Pregnant women are at a higher risk of colonization with the K1 capsular antigen strain of E coli. This strain is also commonly observed in neonatal sepsis. The mortality rate is 8%, and most survivors have subsequent neurologic or developmental abnormalities. Low birth weight and a positive result from cerebrospinal fluid (CSF) culture are predictors of poor outcome. In adults, E coli meningitis is rare but may occur in patients following neurosurgical trauma/procedures or complicating Strongyloides stercoralis hyperinfection involving the CNS.

• Newborns with E coli meningitis present with fever and failure to thrive or abnormal neurological signs. Other findings in neonates include jaundice, decreased feeding, periods of apnea, and listlessness.
• Those younger than 1 month present with irritability, lethargy, vomiting, lack of appetite, and seizures.
• Those older than 4 months have neck rigidity, tense fontanels, and fever.
• Older children and adults have headache, vomiting, confusion, lethargy, seizures, and fever.