Meningitis
Patient presentation:
B.D., a 34 year old otherwise healthy male presented to the emergency room complaining of fevers, head ache, a stiff neck, and photosensitivity.
Diagnosis & treatment:
The patient presented with text book symptoms of meningitis but it would take time to differentiate between viral, bacterial, or fungal meningitis. Upon admission to the hospital the following samples were obtained, blood cultures, urine culture, sputum culture, and a spinal tap was performed. Since it would take a few days for the cultures to return, the patient had an IV started and was immediately started on IV ceftriaxone and vancomycin. Both of these medications are used to treat bacterial meningitis. Since bacterial meningitis poses a higher risk and fatality rate and is not self limiting, like the viral form, he was started on the antibiotics. The patient was also concerned for his young children and his wife. All were encouraged to be checked for meningitis as well because it can be spread through close contact such as respiratory or throat secretions. Those he is living with and working with are at risk for contracting the infection. The young and elderly are at an increased risk for contracting the infection because of their weakened immune system. The patient that presented has a positive prognosis because he came in early with symptoms. He did not let it progress to affect his mentation and nervous system to the point where he was confused or incoherent. Because of his quick treatment and early action no further harm was done to the patient. He continued his IV antibiotic treatment until his culture came back and showed that he had viral meningitis and he was discharged home and encouraged to stay hydrated and rest.
So what is meningitis?
Meningitis is an inflammation of membranes that cover the brain and spinal cord and can cause damage to the brain, learning disabilities, or hearing loss and at times become fatal if left untreated. Both viral and bacterial meningitis have vaccines that can help prevent the contraction and spread of the disease.
Case created by Brittany Dickman, 2010.