A 23-year-old woman presents with a fever of 103°F, headache, nausea, vomiting, photophobia, and meningismus. In the ED, she becomes increasingly lethargic. What condition is she likely to have, and what is the causative organism in the Gram stain of her CSF, shown above?
This patient displays signs of meningitis. The gram stains of her CSF Gram-negative diplococci, characteristic of Neisseria Meningiditis. These diplococci can be seen in the center of the image as small pink organisms in the shape of a figure 8.
ReplyDeleteThe classic triad of meningitis is fever, headache, and stiff neck (nuchal rigidity). Patients with bacterial meningitis may also have an altered (i.e. decreased) level of consciousness, and complain of photophobia, nausea, and vomiting. In contrast, patients with viral meningitis present with the same complaints, but are awake and alert.
Photo courtesy of: Department of Pathology, The Johns Hopkins Medical Institutions
Explanation courtesy of: Principles and Practice of Hospital Medicine