A 20-year-old healthy woman has a 2-day history of fever, headache, vomiting, and photosensitivity, she takes no medications. On examination, she is alert and oriented with a Temp 38,5°C, BP 100/60mmHg, HR 110/min, and RR 14/min. Nuchal rigidity is noted. No evidence of the papilledema, Neurological examination findings are non- focal. Lumbar puncture is performed. CSF Analysis shows leukocyte count 200/uL. with 90% lymphocytes, erythrocyte count 10/uL, glucose 60mg/dl and gram stain is negative, Plasma glucose is 100mg/dl. Which of the following is the most likely diagnosis in this patient?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: B. Aseptic meningitis
The CSF shows a modest lymphocytic pleocytosis (200/uL, 90% lymphocytes), normal glucose (60 mg/dL, about 0.6 of plasma) and a negative Gram stain. This pattern is aseptic (usually viral) meningitis. Bacterial meningitis gives neutrophils and low glucose. TB and fungal meningitis are lymphocytic too but characteristically have low glucose.
ليش كل خيار صح أو غلط
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A
ليش غلط
Bacterial meningitis gives a neutrophil-predominant WBC rise, low glucose and high protein. Here the cells are 90% lymphocytes and the glucose is normal.
✓ Step Up To Medicine 6th Edition 2024 (CNS INFECTION).pdf · p. 4 -
B
ليش صح
Aseptic meningitis gives a lymphocytic pleocytosis, normal or slightly raised protein and usually normal glucose. This CSF (90% lymphocytes, glucose 60 vs plasma 100) fits.
✓ Step Up To Medicine 6th Edition 2024 (CNS INFECTION).pdf · p. 4 -
C
ليش غلط
TB meningitis is also lymphocytic, but it is associated with low glucose. Her CSF glucose is normal (60 mg/dL, about 0.6 of plasma).
✓ Step Up To Medicine 6th Edition 2024 (CNS INFECTION).pdf · p. 4 -
D
ليش غلط
Fungal meningitis is also lymphocytic, but it is associated with low glucose. Her CSF glucose is normal.
✓ Step Up To Medicine 6th Edition 2024 (CNS INFECTION).pdf · p. 4
- المصدر
- Step Up To Medicine 6th Edition 2024 (CNS INFECTION).pdf · p. 4
- المحاضرة
- Antimicrobials · Infectious Diseases · Module B
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