CASE 4
An 18 year old college student is brought to the infirmary by his roommates with a 12 hour history of fever and chills followed by headache and confusion progressing over the past two hours. He has been in excellent health. On physical examination, the temperature is 40.1 C, pulse 110/min, blood pressure 110/70 and respiratory rate 24/mint (Normal 12-16/min). He is somnolent but combative when aroused. The skin shows scattered petechial hemorrhages, 0.31.0 cm in diameter, on the face trunk and extremities. The neck is rigid and Kernig's sign is positive. Lumbar puncture discloses an opening pressure of 24 cm H2 O (normal 10-20 cm H2O) and slightly cloudy fluid.
CBC
| Hg | 15.2 gm/dL |
| WBC | 14.7 x 103/mm3 |
| Differential | 30 seas, 45 bands, 20 lymphs, 5 monos |
| Platelet count | 94,000/mm3 |
CSF
| WBC | 450/mm3 with 94% seas |
| Glucose | 9 mg/dL |
| Protein | 110 mg/dL |
1. Describe succinctly the Meningitis. Answer
2. Describe the offending organism of this case, its morphologic, cultural characteristics and their normal habitat? Answer
3. What kinds of hosts are susceptible? Answer
4. How do these organisms gain access to humans? Answer
5. How do they invade and spread in humans? Pathogenicity. Answer
6. What defenses humans have against these organisms? Answer
7. How do these organisms able to overcome human defenses? Answer
8. What is the end result of this battle between organisms and humans? Answer
9. What are the symptoms from N. meningitis? Answer
10. What are the physical findings of N. meningitis? Answer
11. How do you diagnose this infection? Answer12. What will be your therapeutic strategy? Answer
13. How can you prevent it from spreading to others? Prevent its occurrence? Answer