Microbiology

Meningitis Case Study #3

Patient A: A 73-year-old Guatemalan man namedFrancisco Salazar was brought into the ER by his daughter with achief complaint of a 5-day history of fever, back and neck pain,headache, and confusion. Francisco’s daughter notes that they liveon a dairy farm and he has a history of cirrhosis and non-insulindependent diabetes. A lumbar puncture was performed forcerebrospinal fluid (CSF) analysis.

Patient B: Alice Chen, a 6-year-old female,presented to the emergency department with a 4-day history ofworsening headache and a rash on her trunk. Her mother mentionedthat over-the-counter medications had no effect on her headache.Alice mentioned that the bright lights of the examination room hurther eyes and she stated that her “head hurts all over.” She alsohad difficulty trying to move her neck. A physical test revealedsome vesicular lesions on her hands and feet. A lumbar puncture wasalso performed for cerebrospinal fluid analysis.

	Normal CSF ranges	Patient #A	Patient #B
Leukocytes (per mm3)		1145	115
% Neutrophils		70	30
Glucose (mg/dL)		20	54
Protein (mg/dL)		410	53

Patient A has Bacterial Meningitis

Patient B has Viral Meningitis

What specific disease do they have, how do you treat it, andwhat is the prognosis