The EM Educator Series: Meningitis – Unusual Headache and Fever
EM Educator returns with meningitis.
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meningitis
EM@3AM: Bacterial Meningitis
A 21-year-old male is brought to the ED via EMS after a reported seizure. As per girlfriend, the patient began complaining of a headache yesterday, and today he is confused. He is febrile and tachycardic. He is confused and has nuchal rigidity. However, Kernig and Brudzinki signs are negative. CT is negative. What is most likely diagnosis, and what is the next step in diagnosis?
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Medical Malpractice Insights: Missed meningococcemia in the midst of a meningitis outbreak
Dr. Pilcher returns with a tough case of missed meningococcemia during a meningitis outbreak.
Medical Malpractice Insights: Delayed Care, Poor Handoff, Multiple Errors
Dr. Pilcher brings you a difficult case of a 2-year-old with meningitis.
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Bacterial Meningitis in Children
Let us take a brief moment to remember a once common concern that is, fortunately, less often seen – Meningitis in Children.
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Meningitis – Why do we miss it… How do we improve?
How can we improve our diagnosis of meningitis? This post looks at this and more.
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The Sick Meningitis Patient – From Bad to Worse
What should you do with the critically ill patient with meningitis?
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The Bloody CSF Tap – Pearls and Pitfalls
What do you do with the CSF sample with blood in suspected subarachnoid hemorrhage or meningitis? This post looks at the evidence behind those pesky RBCs.
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Medical Malpractice Insights: Bounceback Babies
This month’s Medical Malpractice Insights looks at a difficult case of multiple ED visits in a pediatric patient and the importance of documented medical decision making and return precautions.
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Sinusitis Mimics: ED-relevant pearls and pitfalls
Your next patient is a 17-year-old male you had seen one week before for fever and congestion, diagnosed with a viral upper respiratory infection. He returns this time for nasal congestion, severe frontal headache, fevers, sore throat, and nasal drainage. When he looks around the room, he gets dizzy and is seeing double. He is febrile, tachycardic, and ill appearing, and you note proptosis of the right eye, a sluggish pupil, and inability to move the eye due to pain. Is this sinusitis, or something more sinister?
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