Answers To Case 29 Bacterial Meningitis

Summary: A 20-year-old college student presents with a 3-day history of fever, headache, myalgias, and nausea. He has no respiratory or gastrointestinal symptoms, hut now has developed photophobia. He is febrile to I02.3°F. tachycardic. and normotensive. His physical examination is generally unremarkable with a nonlocal neurologic examination but some neck stiffness, suggesting meningeal irritation. He has no skin lesions as might be seen in meningococcemia.

^ Condition most likely concern: Meningitis.

♦ Diagnostic test to confirm diagnosis: Lumbar puncture (LP) for evaluation of the cerebrospinal fluid (CSF). possibly preceded by a CT scan of the head.

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