RT Book, Section
A1 Kelly, Elizabeth W.
A1 Fitch, Michael T.
A2 Sherman, Scott C.
A2 Weber, Joseph M.
A2 Schindlbeck, Michael A.
A2 Rahul G., Patwari
SR Print(0)
ID 1101225002
T1 Meningitis and Encephalitis
T2 Clinical Emergency Medicine
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179460-2
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1101225002
RD 2024/04/18
AB The  classic  triad  of  meningitis  includes  fever,  neck  stiffness,  and  altered  mental  status.  However,  all  3  of  these  are  present  less  than  half  of  patients  with  bacterial  meningitis.Patients  who  are  very  young,  very  old,  or  immunocompromised  may  present  with  atypical  signs  and  symptoms.Empiric  antibiotics  should  not  be  delayed  while  waiting  for  a  computed  tomography  (CT)  scan  before  a  lumbar  puncture  (LP)  if  meningitis  is  a  likely  diagnosis.  When  a  CT  scan  is  necessary,  draw  blood  cultures  and  administer  steroids  and  appropriate  antibiotics  before  the  LP.Consider  the  diagnosis  of  herpes  simplex  virus  encephalitis  in  patients  with  focal  neurologic  findings  or  altered  mental  status  and  add  intravenous  acyclovir  to  the  empiric  antimicrobial  regimen.