Microbiology Problem Louis Hofherr pp.517-519
Published Date 1979/6/1
DOI https://doi.org/10.11477/mf.1543201865
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A 6-year-old Caucasian*1 female was admitted to the hospital with complaints of abdominal pain and neck stiffness. Her temperature was 38.8C. Her blood pressure was 80/56; pulse rate, 118; respiratory rate, 26. The patient vigorously resisted any attempt to flex her neck. The Kernig and Brudzinski signs were positive. The Babinski response was normal. The initial clinical impression*2 was that the patient had meningitis. See Table I for results of admission laboratory tests*3. The unexpected finding*4 of a clear spinal fluid with no cells or bacteria influenced the clinical diagnosis. In view of these findings, early aseptic meningitis was diagnosed. The spinal fluid was cultured on a chocolate agar plate only. After eighteen hours, the laboratory reported a gram-negative diplococcus morphologically resembling Neisseria meningitidis cultured from the spinal fluid. The gram smear is seen in Figure 1. Therapy was immediately switched from symptomatic and supportive*5 to use of ampicillin*6, administered by intravenous drip.

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