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Steroid and Scan?: The Dilemmas of Meningitis

A 31-year-old male with no significant past medical history presents with a fever of 39C and a bifrontal throbbing headache with photosensitivity for 1 day. He has also had nausea and 3 episodes of non-bloody, non-bilious emesis. He denies recent trauma, rash, recent travel, and sick contacts. There is no altered mental status. On physical exam, he has photophobia but no neurological deficits. He complains of a stiff neck but has negative Kernig and Brudzinski signs. He has normal heart, lung, and abdominal exams. What’s on the top of your differential diagnoses? Meningitis! It’s important to not delay meningitis workup and treatment because without treatment, the case fatality rate can be a

Stony Brook
EMergency Medicine

(631) 444-3880


101 Nicolls Road,

Stony Brook, NY 11794

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