The EM Educator Series: Meningitis – Unusual Headache and Fever

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case 1:

A 37-year-old male with with a history of polysubstance abuse presents with confusion and unilateral weakness. Vital signs reveal fever.


Case 2:

A 22-year-old female presents with fatigue, headache, and neck pain. She recently completed a course of antibiotics for sinusitis, but she otherwise has no past medical history.



  • What are the major risk factors for meningitis?
  • How can patients present with meningitis?
  • What are high yield components of the history and exam?
  • What labs should be obtained?
  • When is CT recommended?
  • What are considerations with antibiotics?
  • When are steroids recommended?


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