A 19-year-old previously healthy male college student presents to the emergency department with a 2-day history of fever, severe headache, and neck stiffness. He reports that this morning he developed a productive cough with purulent sputum. Vital signs are: temperature 39.5°C, heart rate 108/min, blood pressure 122/78 mmHg, respiratory rate 20/min, and oxygen saturation 97% on room air. Physical examination reveals nuchal rigidity and a petechial rash on his trunk and lower extremities. Chest X-ray shows a left lower lobe consolidation. Lumbar puncture yields cerebrospinal fluid with protein 145 mg/dL, glucose 32 mg/dL (serum glucose 98 mg/dL), and elevated opening pressure. Which of the following organisms is most likely responsible for this patient's concurrent meningitis and pneumonia?
- A)Haemophilus influenzae type b
- B)Listeria monocytogenes
- C)Neisseria meningitidisGABARITO
- D)Mycobacterium tuberculosis
- E)Streptococcus pneumoniae
Explicação
Neisseria meningitidis is a gram-negative diplococcu that classically presents with acute meningitis and concurrent pneumonia in young adults, particularly in closed environments like college dormitories. The petechial rash is highly characteristic and essenti... Ver explicação completa e trilha adaptativa →