Background <p>The probable association of <i>Toxoplasma gondii</i> (<i>T.gondii</i>) flare-up/co-existence with bacterial meningitis is yet to be elucidated. This study aimed to investigate the possible incidence of <i>T.gondii</i> flare-ups in the cerebrospinal fluid (CSF) suspected of bacterial meningitis as a hidden co-morbid factor. The causative organisms of bacterial meningitis, antibiotic resistance patterns, and physiological aspects of CSF among various age groups were all assessed.</p> Methods <p>A cross-sectional study in Almaza Military Hospital, Emergency Department, involved 300 Egyptian patients with symptoms suggestive of meningitis, out of whom 51/ 300 (17.0%) were confirmed by chemical and physiological parameters and microbiological analysis to have bacterial meningitis. Based on age, the patients were divided into Group-1 (&lt; 30 years old) and Group-2 (&gt; 30 years old). The obtained CSF samples were assessed for bacterial growth, antibiotic sensitivity, physiological criteria, and chemical parameters (protein, glucose, and chloride). <i>Toxoplasma</i> was detected using both immune and molecular assays.</p> Results <p>Overall, 51 (17%) out of 300 patients were confirmed for bacterial meningitis. Males constituted 66.7%. Group-1 consisted of 41 patients (80.4%) distributed as infants (<i>n</i> = 30, 58.8%), children (<i>n</i> = 7, 13.7%), and neonates (<i>n</i> = 4, 7.8%) (<i>P</i> &lt; 0.001) (males 63.4% and females 36.6%). Group-2 involved 10 patients (19.6%), (males 80% and females 20%). Overall, 49% of the patients received empirical antibiotics, and bacterial growth was present in 51% of the cases. <i>Enterobacter</i> spp. was the most prevalent type of bacteria (15.7%), whereas <i>Pseudomonas</i> and <i>Acinetobacter</i> spp. were the least (2% each). Neonates and children (in subgroup-1) predominantly showed Methicillin-resistant <i>Staphylococcus aureus</i>. 73.7% of infants (subgroup-1) and 80% of group-2 had multidrug-resistant bacteria. Bacterial growth was associated with higher neutrophil count and lower glucose and chloride levels. In group-1, females had a significant increase in neutrophils. The CSF glucose was negatively correlated with neutrophils (<i>r</i>=-0.467) and positively correlated with chloride (<i>r</i> = 0.4). The CSF protein level was positively correlated with neutrophils (<i>r</i> = 0.308), while the chloride level was negatively correlated with neutrophils (<i>r</i>=-0.416) and protein (<i>r</i> = -0.601). The anti-<i>Toxoplasma</i> IgG was positive in 23.5% of cases, indicating exposure to <i>Toxoplasma gondii</i>. All patients were negative for anti-<i>Toxoplasma</i> IgM and the Repeat element (RE) gene. Chronic cerebral toxoplasmosis was higher in the female patients (<i>P</i> = 0.0016).</p> Conclusions <p>Despite the variable demographic data, bacterial species, antibiotic resistance, and altered CSF physiological and chemical parameters, toxoplasmosis flare-ups and bacterial meningitis lacked association.</p>