TY - CHAP M1 - Book, Section TI - Bacterial Meningitis A1 - Gajera, Mithil A1 - Czosnowski, Quinn A. A1 - Rincon, Fred A2 - Lee, Kiwon PY - 2012 T2 - The NeuroICU Book AB - An otherwise healthy 29-year-old man is brought in to the emergency department (ED) because of 2 days of headache, flu-like symptoms, fever, and change in sensorium. On arrival at the ED his vital signs were: temperature 103.3°F, heart rate 138 bpm, respiratory rate 24 to 32 breaths/min, blood pressure 88/48 mm Hg, saturation 88% (room air), and Glasgow Coma Scale (GCS) 10. The patient's general examination revealed a patient in mild distress, injected conjunctivae, erythematous throat, pallor without cyanosis, petechial rash in lower extremities, nuchal rigidity, and normal cardiac and lung examination. Abdomen was mildly tender but no peritoneal signs were elicited. He was stuporous but arousable to loud voice and strong painful stimulation, he was able to follow some simple commands but inconsistently. Cranial nerves were normal and fundus did not show papilledema. He was localizing briskly with the upper extremities and withdrawing appropriately with both lower extremities. Reflexes were three-fourths throughout. A Foley catheter was inserted, obtaining only 10 mL of dark urine. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - neurology.mhmedical.com/content.aspx?aid=1101642774 ER -