81 y/o febrile Male from Texas presented with AMS & progressive symptoms of b/l LE weakness for 5 days.
2 sets blood culture
L P (r/o elevated ICP first)
IV Ceftriaxone+ Vancomycin + Ampicillin+ Acyclovir
IV Dexamethasone (reduces complications)
(to cover S.peumoniae, N. meningitidis, Listeria, HSV)
CSF Analysis:
CBC: Plt: 144K
WBC: 80 ( ) lymphocyte predominant protein: 80 ( ) glucose: 60
Lymphocytic pleocytosis
think viral
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