Question

Meningitis Case Study #3

Patient B: Alice Chen, a 6-year-old female, presented to the emergency department with a 4-day history of worsening headache and a rash on her trunk. Her mother mentioned that over-the-counter medications had no effect on her headache. Alice mentioned that the bright lights of the examination room hurt her eyes and she stated that her “head hurts all over.” She also had difficulty trying to move her neck. A physical test revealed some vesicular lesions on her hands and feet. A lumbar puncture was also performed for cerebrospinal fluid analysis.

	Normal CSF ranges	Patient #A	Patient #B
Leukocytes (per mm3)		1145	115
% Neutrophils		70	30
Glucose (mg/dL)		20	54
Protein (mg/dL)		410	53

Question 1: What type of meningitis do the patients have? What could be the pathogens?

Questions 2: What specific staining and cultures of your patients' CSF samples would help identify the pathogen, and why?

Question 3: What specific Serological or Biochemical Tests would be ordered to help identify the viral pathogens, and why?

Question 4: Final Report: Final Diagnosis, Treatment, and Prognisos for each patient.

Answer 1

Answer of the question no 1 is-

The patient A has  bacterial meningitis and patient B has viral meningitis.

The pathogens for bacterial meningitis could be Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Listeria monocytogenes etc and the pathogens for viral meningitis could be enteroviruses, herpes simplex virus,HIV, mumps etc .

Answer of the question no 2 is-

Gram staining and culture of patients' CSF sample would help identifying the pathogens because gram staining is a very sensitive procedure to identify the disease causing bacteria.Gram staining help to identify gram positive and gram negative meningitis causing bacteria.In this staining process, gram positive bacteria will exhibit purple or dark violet colour and gram negative bacteria will exhibit red or pink colour and thus, it is very helpful in identifying meningitis causing bacterias.

Answer of the question no 3. is-

To identify viral pathogens , PCR (Polymerase chain reaction) test can be ordered. Besides this, antibody detection test for particular viruses can also be done to identify viral pathogens. Because, PCR help to amplify the geneic materials present in virus and thus, virus causing meningitis can be detected easily. Antibody tests also help to detect viruses causing meningitis because particular antibodies can only be present as a result of the presence of that particular viruses(antigen).

Answer of the question no 4. is-

Diagnosis of bacterial meningitis- Culture of blood sample,culture of CSF sample and gram staining, X-ray, CT scan, MRI of head, chest etc.

Treatment of bacterial meningitis-It can be treated with various antibiotics.

Diagnosis of viral meningitis-PCR or antibody detection test .

Treatment of viral meningitis- Most of the patient with mild viral meningitis does not require any treatment. It can be cured within some days. In severe cases it can be treated with antiviral drugs.