Question

Microbiology

Meningitis Case Study #3

Patient A: A 73-year-old Guatemalan man named Francisco Salazar was brought into the ER by his daughter with a chief complaint of a 5-day history of fever, back and neck pain, headache, and confusion. Francisco’s daughter notes that they live on a dairy farm and he has a history of cirrhosis and non-insulin dependent diabetes. A lumbar puncture was performed for cerebrospinal fluid (CSF) analysis.

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

Patient A has Bacterial Meningitis

Patient B has Viral Meningitis

What specific disease do they have, how do you treat it, and what is the prognosis

Answer 1

Patient A has Meningococcal meningitis – caused by the organism Neisseria meningitidis bacteria.

Treatment include-Treatment can be started with ov antibiotics or corticosteroids depending on the condition of the patient

Vancomycin plus cefotaxime or ceftriaxone is considered effective for the meningitis

Age 1 mo-50 y: Vancomycin plus cefotaxime or ceftriaxone*

Age or Predisposing Feature: Antibiotics

Age 0-4 wk: Ampicillin plus either cefotaxime or an aminoglycoside

There is a 10 percent death rate from bacterial meningitis, but if diagnosed and treated early enough, most people recover.but if not treated then it may cause severe defects like paralysis seizures or even death of the patient.

Patient B is suffering from Herpes meningoencephalitis caused by herpes virus antiviral acyclovir is used to treat it. You may need to take this medicine through an intravenous (IV) line for 10 to 14 days.Herpes simplex encephalitis (HSE) is a rare but severe condition. In the absence of treatment, prognosis is extremely poor, with a mortality rate of about 70 % so if treated early the chances of survival is much more.