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Washington University Experience | INFECTION | Bacteria | Meningitis | Meningitis, complications - acute | 14A0 Case 14 History
Case 14 History ---- This is a 2-year-old boy with acute onset of vomiting, lethargy and fever to 104 oF. LP was thought to be inconsistent with meningitis (total cells 3, nucleated cells 1, PMN 89%, protein 33, glucose 56). Upon arrival to the PICU, he was noted to be stuporous, with meningismus, tachypneic, tachycardic, with cool extremities with weak pulses. During the course of the admission exam, he developed a rapidly progressive erythematous, nonblanching rash over the face and trunk, which were felt to represent early purpura. He was resuscitated with aggressive fluids, and pressors. He received escalating pressors for cardiovascular collapse, but he continued to deteriorate. He suffered several cardiac arrests, and could not be resuscitated from the last one. Clinical diagnosis was purpura fulminans. CSF as well as blood cultures eventually grew Neisseria meningitidis.
