QuestionSBA
QuestionChoice
A fungal cause of meningitis such as a Cryptococcus species is most likely when the patient is immunocompromised. A high opening pressure on lumbar puncture is also associated with fungal meningitis. In this case, the patient is otherwise fit and well, and the CSF results indicate bacterial meningitis. This answer is therefore incorrect.
10025484
e
Cryptococcus
QuestionChoice
The presence of neck stiffness and a non-blanching rash suggest a diagnosis of bacterial meningitis. By contrast, rubella is characterised by lymphadenopathy of the head and neck. Although pyrexia and a rash are also seen in rubella, the rash tends to start on the face before spreading to the body. This answer is therefore incorrect.
10025483
d
Rubella
QuestionChoice
This presentation is in keeping with bacterial meningitis. In adult populations, Streptococcus pneumoniae is one of the most common causes of meningitis.
10025480
a
Streptococcus pneumoniae
QuestionChoice
The herpes simplex virus is a common cause of viral meningitis. In this case, the presence of low glucose levels within the CSF indicates bacterial meningitis. This answer is therefore incorrect.
10025481
b
Herpes simplex virus
QuestionChoice
This presentation is in keeping with bacterial meningitis. Staphylococcus aureus is a bacterium commonly associated with skin and soft tissue infections. It is not commonly implicated in meningitis, making this answer incorrect.
10025482
c
Staphylococcus aureus
Concept
Chapter
2693
3751
Meningitis
Topic
141
Neurology
17494
An 18-year-old male is brought to A&E by his flatmate, who is concerned that he has started behaving strangely over the past few hours. The patient confirms feeling muddled and reports that his neck feels stiff when he tries to move it. On examination, he is pyrexial with a new rash across both legs that does not fade when held against a glass. He is usually fit and well, and has just started studying at university.

A lumbar puncture is performed. Cerebrospinal fluid (CSF) analysis shows raised protein levels with low glucose.

Which of the following microorganisms is the most likely cause of this patient's symptoms?
a