Meningitis and encephalitis are medical emergencies, where timely recognition and treatment are vital to reducing morbidity and mortality. Despite established clinical guidelines, delays in antibiotic administration, unnecessary neuroimaging, and inconsistent corticosteroid use are prevalent. Prior studies have found socioeconomic influence on meningitis outcomes. However, the role of race, ethnicity, and sex in the timeliness of care for suspected cases remains understudied.

We performed a retrospective chart review of adults admitted to Cooper University Hospital (January-May 2025) who underwent lumbar puncture for suspected meningitis or encephalitis. Demographics, timing metrics, and outcomes were extracted from the electronic medical record. Primary outcome was time to lumbar puncture, analyzed across sex, race, and ethnicity. Secondary outcomes included time to antimicrobial administration and time to blood culture collection. Differences between groups were compared using the Mann–Whitney U test.

Sixty-six patients met inclusion criteria. The median time to lumbar puncture was 2,155 minutes, while the median time to antimicrobial administration was 671 minutes. Timing of lumbar puncture was significantly shorter among Hispanics versus non-Hispanics (median = 837.5 [IQR: 407-1275] vs 2697.5 [IQR: 976-5373], p=0.007), and differed significantly by race, with Black patients experiencing shortest times compared with White and other races (median = 982 [IQR 531-3631] vs 2878 [IQR: 1820-5634] vs 1027.5 [IQR: 427-1582], p=0.012); no significant differences were observed by sex. Antimicrobial administration and blood culture collection timing were consistent across groups.

Our findings reveal significant ethnic and racial disparities in lumbar puncture timing for suspected meningitis or encephalitis, highlighting the urgent need to identify and address implicit biases and systemic barriers that may contribute to inequities in care within neurological emergencies.