المعلومة
مريض اتى بـ:
اقياء vomiting، حمى Fever، صلابة نقرة Stiff neck، غثيان Nausea، صداع Headache ،قصة ذهاب الى احد المسابح العامة قبل اسبوع....
شو بتعمل,وبشو بتفكر؟؟
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المراجع عند كتابة الجواب...
Mon, 2008-03-24 01:10

mbs2380
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Next step: NP?
what is an NP??
LP مو NP
البزل القطني lumbar puncture
so ,your diagnosis is partitially right,and your next step is right also...
and it is meningitis because of the clinical findings ,and from the history of the patient we find that he went to a "swim pool" which makes me think of Naegleria fowleri which con lead to meningitis in one week and can lead to death if the patient untreated ,so the next step that I would make is Gram stain and a CSF exam to make sure of my diagnosis ....
Gram stan in this case would be negative ....
so I will start with rifampicine and mecanazole
in one week also
References:made ridiculously simple
The book of our UNI .
thx
Naegleria fowleri

menengitis the is the most common intracranial complication of otitis media