12-20-2008, 01:06 PM
A 25-year-old Caucasian male presents with a 1 week history of headaches, runny nose, nausea, fever and general discomfort. Physical examination reveals mild meningeal irritation without other findings. His Temperature is 38.3C(100.9F). You recommend admission to hospital and lumbar puncture, to exclude meningitis. The patient refuses to undergo the procedure. What would you do?
A. Let him go home
B. Force him to stay in hospital against his will
C. Counsel him properly about the risks of having untreated meningitis, let him go and state he can always come back
D. Have him sign a paper that he understands he can die if he has bacterial meningitis and it is left untreated
E. Explain him everything over and over until he understands, stays in hospital and allows you to do a lumbar tap on him