A 25-year-old male is admitted with a 24-hour history ofsevere headache, nausea and vomiting. Onexamination, he has a temperature of 39°C, a heart rate of 110 bpmand his blood pressure is 90/70 mmHg. There is no evidence of skinrashes. He has neck stiffness and photophobia but no localisingneurological signs. Bacterialmeningitis is suspected.
He had a splenectomy 6 months ago following a roadtraffic accident but otherwise has no past medical history of note.He is not on any regular medication. He has had no known contactwith anyone with meningitis.
A. List THREE importantbacterial causes of community-acquired meningitis in adults (onlyyour first three will be assessed). For each organism, explain whyit is likely or unlikely to be the pathogen in thispatient.
B. State three specimens would you send as part of themicrobiological investigation of this patient and theinvestigations you would request on each specimen.
C. Describe the results you would expect to confirm yourdiagnosis of bacterial meningitis.
D. Explain why this patient was at risk of bacterial meningitis anddiscuss the measures that could have been taken to preventit.
