12-09-2016, 06:33 AM
A 12-year-old girl is brought to the emergency department by her parents because of a 3-day history of fever and a
12-hour history of lethargy. Her parents say that she has been sleeping most of the day and has been unresponsive
when awake. Her temperature is 39.2°C (102.6°F). Physical examination shows numerous petechial hemorrhages
and nuchal rigidity. A lumbar puncture yields cloudy cerebrospinal fluid (CSF) that clots in the collection tube.
Microscopic examination of the CSF shows numerous segmented neutrophils, and a Gram stain shows gramnegative
diplococci. Which of the following is the most likely causal organism?
(A) Haemophilus influenzae
(B) Mycoplasma pneumoniae
© Neisseria meningitidis
(D) Salmonella typhi
(E) Streptococcus pneumoniae
12-hour history of lethargy. Her parents say that she has been sleeping most of the day and has been unresponsive
when awake. Her temperature is 39.2°C (102.6°F). Physical examination shows numerous petechial hemorrhages
and nuchal rigidity. A lumbar puncture yields cloudy cerebrospinal fluid (CSF) that clots in the collection tube.
Microscopic examination of the CSF shows numerous segmented neutrophils, and a Gram stain shows gramnegative
diplococci. Which of the following is the most likely causal organism?
(A) Haemophilus influenzae
(B) Mycoplasma pneumoniae
© Neisseria meningitidis
(D) Salmonella typhi
(E) Streptococcus pneumoniae