Question

Case Study #2 Clinical history:A 33-year-old female dairy farmer develops a severe headache unrelieved by medication and neck stiffness. On physical examination, her temperature is 38.2°C. She has no papilledema. (Papilledema is a condition in which increased pressure in or around the brain causes the part of the optic nerve inside the eye to swell. Symptoms may be fleeting disturbances in vision, headache, vomiting, or a combination of these.) A lumbar puncture is performed, and a Gram stain of the CSF obtained shows many short, gram-positive rods and also a proliferation of segmented neutrophils. Martha Lepow MD Read the clinical history CAREFULLY. That is all the information you need to suggest a diagnosis. Of course, a complete diagnosis will depend on laboratory findings after culture and sensitivity. But, just based on the information here, the patient can be started on a regimen of treatment. Therefore, based on the clinical findings presented, what is the most likely causative agent in the case above? What treatment should she receive now, pending final laboratory results later?

Answer 1

The clinical symptoms of severe headache and beck symptoms are typical signs of Meningitis. The causative agent can be likely listeria because this can be spread by the cattles to humans as a zoonotic disease.

The treatment which can initiated are

• Antibiotics to treat infection
• Analgesics to relieve pain
• Antipyretics to reduce body temperature