Other emergencies
Case 23: A Patient with Severe Headache, Vomiting and Photophobia
CASE
A 24‐year‐old student presents with a 24‐hour history of severe headache, vomiting and photophobia. Neurological examination was normal. His temperature was 38°C. He was noted to have neck stiffness and a petechial rash. A CT scan showed no evidence of raised intracranial pressure. A lumbar puncture was undertaken which showed increased protein, reduced glucose and increased white cell count (predominantly neutrophils) in the CSF. Gram stain revealed Gram‐negative diplococci. On reviewing his history he had previously been treated for an episode of Neisserial meningitis at the age of 14 but there is no other history of infections. His younger brother also had an episode of meningitis aged 10 years.
QUESTION 1
Your score this session: 0 of 0
What is the most likely underlying cause for his recurrent meningitis?