RT Book, Section
A1 Gajera, Mithil
A1 Czosnowski, Quinn A.
A1 Rincon, Fred
A2 Lee, Kiwon
SR Print(0)
ID 1101642774
T1 Bacterial Meningitis
T2 The NeuroICU Book
YR 2012
FD 2012
PB McGraw-Hill Education
PP New York, NY
SN 9780071636353
LK neurology.mhmedical.com/content.aspx?aid=1101642774
RD 2024/04/19
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.