Once the patient had been admitted to the hospital's critical care unit, intravenous fluids were started.  Included were penicillin G, steroids, and essential fluid and nutrient replacements. Nursing care is intensive to include monitoring neurologic parameters for seizures, blood pressure, temperature, fluid replacement, administration and others.

 

The neurologist ordered a standard radiograph (X-ray), as well as a computerized axial tomograph (CAT) scan of the patient's cranium to determine the extent of swelling caused by the inflammatory presence of the bacteria.

 

14.  Can you explain how a CT scan works?

15.  Why would a physician request a CT scan over an X-ray?  

16.  Why would an X-ray be ordered over a CT scan?

 

48 hours after the lumbar puncture, spinal fluid and blood  cultures confirmed the presence of Neisseria meningiditis. Click here if you are interested in seeing the nature of this organism in the laboratory. 

 

17.  Which health professional would be responsible for running the tests to detect bacterial meningitis?

 

Instructor's Notes:

Since bacterial meningitis is a highly infectious disease and poses a public health threat, states require physicians to immediately report the case to departments of public health.  A state or county epidemiologist. individuals trained to follow community diseases, follow standard protocols set forth by the Centers for Disease Control to assure proper follow-up with individuals that have been in close contact with the patient. Close contacts are defined as individuals who may have had contact with the patient's saliva through kissing, sharing drinking straws and a number of other interactions. These are usually household members and girlfriends/boyfriends.  In these cases, the close contacts must be treated with prophylactic (preventative) antibiotics and closely watched for signs of the disease.  Since the patient attended a school, the local health agency, usually the county health department, sends a notification to parents as a precaution. Such notices advise the parents of signs and symptoms of meningiococcal meningitis and encourage the parent to seek medical care for their child quickly if the child exhibits any one of those symptoms.

 

For a more detailed description of this process, interested students can visit the CDC public health guidelines website listed in Additional Resources.

 

The patient responded well to all medications and supportive care.  He was kept in the hospital's intermediate care unit for several days and then discharged.