Question 1

A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?&#10;A) If the serum C-reactive protein is greater than 10 mg/L&#10;B) Immediately after blood and spinal cultures are obtained&#10;C) Prior to obtaining a computed tomography (CT) scan or lumbar puncture (LP)&#10;D) When initial spinal fluid gram stain results are available

Accepted Answer

C

Question 2

A patient is brought to the emergency department with fever, lethargy, and headache. No meningeal signs are noted. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient's trunk. What do these findings indicate?

A) Progressing meningococcemia
B) Encephalitis
C) Increased intracranial pressure (ICP)
D) Probable viral infection

A

Accepted Answer

The combination of fever, lethargy, headache, hypotension, and petechiae is highly suggestive of meningococcemia, a potentially life-threatening bacterial infection. It requires immediate diagnosis and treatment with intravenous antibiotics. Encephalitis generally presents with fever, headache, and signs of neurological dysfunction like seizures, altered consciousness, or focal neurological deficits. Increased ICP typically presents with headache, vomiting, and signs of raised intracranial pressure, like papilledema or altered consciousness. Probable viral infection does not fit with the petechiae and hypotension.

Deck 178: Infections of the Central Nervous System