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Question
A 19-year-old college student was in her usual state of health when she came home for the weekend. The evening prior to admission, she went to bed with a headache and slight fever. The next morning, her mother found her in bed moaning and lethargic. She was brought to the ER, where she appeared toxic and drowsy, but oriented. Her temperature was 40C, increased heart rate, and her BP was 100/60 mmHg. She had a purpuric rash on her trunk and legs, and grimaces in pain when her head is turned. His WBC count was 26,000/μL with 25% bands. The platelet count was 80,000/μL. Blood cultures were obtained and lumbar puncture performed. Gram smears of both revealed gram-negative diplococci
1. What organism is most likely causing this patient's illness?
2. What population is most at risk for this infection? What complications may arise in these patients?
3. What media would the CSF culture be plated on? What are the key carbohydrate and enzymatic characteristics that are useful in identifying this organism?
4. What is the antimicrobial currently recommended for treatment of infections with this organism? What is the antimicrobial currently recommended for exposed individuals?
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