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Old 12-14-2012
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Default peds Meningitis

A previously healthy 4-year-old boy is brought to the
emergency department 8 hours after the onset of fever and a
diffuse, constant headache. He had been well until 2 days ago
when he developed malaise. Yesterday, he slept more than
usual and had temperatures to 39.2C (102.5F).
Immunizations are up-to-date. He is lethargic and irritable
when aroused. He holds his head extended and cries when his
neck is flexed. Muscle strength is normal, and deep tendon
reflexes are symmetrically increased. A lumbar puncture
yields turbid cerebrospinal fluid. Laboratory studies show:
Serum glucose 120 mg/dL
Cerebrospinal fluid
Opening pressure 250 mm H2O
Glucose 10 mg/dL
Protein 85 mg/dL
Leukocyte count 750/mm3
Segmented neutrophils 95%
Lymphocytes 5%
Erythrocyte count 0/mm3
A Gram stain of cerebrospinal fluid shows gram-negative
diplococci. A CT scan of the head shows no abnormalities.
Which of the following is the most likely causal organism?
(A) Cytomegalovirus
(B) Haemophilus influenzae
(C) Neisseria meningitidis
(D) Streptococcus agalactiae (group B)
(E) Varicella-zoster virus
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  #2  
Old 12-14-2012
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Default

C) Neisseria meningitidis
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  #3  
Old 12-14-2012
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