Kamsi
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A 4-year-old boy, who has a ventriculoperitoneal shunt for congenital hydrocephalus, develops
fever, headache, irritability, lethargy, photophobia, and vomiting. He is up to date on his
childhood immunizations. His temperature is 39.6 C (103.2 F). He is noted to have nuchal
rigidity, with the presence of both Kernig's and Brudzinski's signs. The shunt tract is
erythematous on the surface. A lumbar puncture is performed and shows a WBC of
40,000/mm3 with 85% neutrophils, a glucose concentration of 48 mg/dL, and a protein
concentration of 169 mg/dL. Which of the following is the most likely pathogen?
A. Haemophilus influenzae
B. Neisseria meningitidis
C. Pseudomonas aeruginosa
D. Staphylococcus epidermidis
E. Streptococcus pneumoniae
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| Doc750
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D. Staph
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| titly
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streptococcus pneumoniae
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| hanialkhadher
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D. Staphylococcus epidermidis
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| GOGETA
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E
D is my first instint but something tell me E
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| sandra
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staph epidermidis. period.
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| darkhorse
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S epidermidis
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| DrAlex_76
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D
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| PGI2alpha
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Staph epidermidis
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| Ivonne
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S epidermidis!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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| DrVirgo
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Meningitis in a 4 year old: MCC is
B. Neisseria meningitidis
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| Ivonne
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No. N meningitidis it is the most common cause of meningitis at that age but we the key in this case in the ventriculoperitoneal shunt which is a risk factor for S. epidermidis meningitis.
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| DrVirgo
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good point Kamsi, thanks for explaining..
Kamsi, right answer PLEASE! 
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| ILoveMedicine
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The answer is D
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| cuadrado_g
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D
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