Clinical Pearl


    Clinical Pearl

    28 yo M with no pmh presents with HA, fever, and neck stiffness. He states that he recently came back from a week long business trip to Dallas. You get a CTH that is wnl and LP with results below.

    Pressure Normal

    Appearance Clear

    Protein < 1 g/L

    Glucose wnl

    Gm stain negative

    Lymphocyte predominance / pleocytosis

    What is the diagnosis? What pathogens should be considered? 


    VIRAL MENINGITIS – should consider West Nile Virus (WNV) as over 45% of all cases have been reported from Texas. Over 70 percent of the cases have been reported from six states (Texas, South Dakota, Mississippi, Oklahoma, Louisiana, and Michigan)

    Presents 3-14 days after mosquito bite

    Sx’s: high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis


    CSF Analysis