An 18-year-old college freshman living in a university residence hall develops severe headache, neck stiffness, and fever. When he cannot be aroused, he is transported to the hospital where a Gram stain of a centrifuged cerebral spinal fluid shows Gram-negative diplococci. A latex particle agglutination test confirms the etiological cause of the bacterial meningitis. Which causative agent is most likely?

Question

Quizplus · Accepted Answer

In the specific patient (young adult, new stresses, crowded living conditions such as residence halls or, potentially, college bars), your first suspicion even before the Gram stain and LPA tests should be Neisseria meningitidis, which was confirmed by the Gram stain. E. coli would be unlikely unless he had a CNS shunt or was a neonate. H. influenzae would be unlikely in anyone except a 3-month-old to 5-year-old child who had not been vaccinated as a child.

An 18-Year-Old College Freshman Living in a University Residence Hall