A 25-year-old male is admitted with a 24-hour history of severeheadache, nausea and vomiting. On examination, he has a temperatureof 39°C, a heart rate of 110 bpm and his blood pressure is 90/70mmHg. There is no evidence of skin rashes. He has neck stiffnessand photophobia but no localising neurological signs. Bacterialmeningitis is suspected.
He had a splenectomy 6 months ago following a road traffic accidentbut otherwise has no past medical history of note. He is not on anyregular medication. He has had no known contact with anyone withmeningitis.
A. List THREE important bacterial causes of community-acquiredmeningitis in adults (only your first three will be assessed). Foreach organism, explain why it is likely or unlikely to be thepathogen in this patient.
B. State three specimens would you send as part of themicrobiological investigation of this patient and theinvestigations you would request on each specimen.
Describe the results you would expect to confirm your diagnosis ofbacterial meningitis.
C. Explain why this patient was at risk of bacterialmeningitis and discuss the measures that could have been taken toprevent it.
