11-20-2006, 05:27 PM
A 4-year-old boy, who has a ventriculoperitoneal shunt for congenital hydrocephalus, develops fever, headache, irritability, lethargy, photophobia, and vomiting. His temperature is 39.6 C (103.2 F). He is noted to have nuchal rigidity, with the presence of both Kernig's and Brudzinski's signs. The shunt tract is erythematous on the surface. A lumbar puncture is performed and shows a WBC of 40,000/mm3 with 85% neutrophils, a glucose concentration of 48 mg/dL, and a protein concentration of 169 mg/dL. Which of the following is the most likely pathogen?
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
E. Streptococcus pneumoniae
and what is the most likely treatment
a) Nafcilin
b) penicilin
c) Oxacilin
d) Vancomycin
e) Erythromycin
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
E. Streptococcus pneumoniae
and what is the most likely treatment
a) Nafcilin
b) penicilin
c) Oxacilin
d) Vancomycin
e) Erythromycin
