M.G. is an 8-year-old boy who has been brought to the emergency department by his parents with a fever of 104º F, lethargy, headache, and stiff neck. Laboratory analysis of a spinal tap demonstrates increased white blood cells in the cerebrospinal fluid (CSF).
Discussion Questions 1. What is the most likely cause of M.G.’s signs and symptoms? What is the origin and pathogenesis? What other laboratory findings would be consistent with this etiology? 1. M.G. has signs and symptoms of 104º F fever, lethargy, headache, and stiff neck. These are all of the common signs of meningitis. Meningitis is often mistaken for the flu, which could cause further complications with the infection. There are three different types of meningitis: bacterial, viral, chronic, and fungal. Bacterial meningitis can be cause by a strain of bacteria entering the bloodstream and traveling to the spinal cord or meninges of the brain. Also bacterial meningitis can result from ear or sinus infection and/or skull fractures. Rarely this type of meningitis can be caused by infection preceding a surgical procedure. The most common types of bacterial strains include: Streptococcus pneumoniae, Neisseria meningitides, Haemophilus influenzae, and Listeria monocytogenes. Viral meningitis is usually last a short period of time and can disappear on its own. The virus that is usually spread in this instance in the US is enteroviruses. Chronic meningitis is caused by slow-growing organisms intrude into the area around the brain including the fluid and membranes. Lastly, fungal meningitis is the least common form of meningitis and is usually caused by a strain of fungus called Cryptococcal meningitis. This form of meningitis cannot be transferred from person to person but usually is associated with patients that have weak immune systems. Just from the signs and symptoms it would be hard to pinpoint