Joe, a 27-year-old white male teacher who works out daily at the gym, begins to complain of a headache and feeling like he is coming down with the flu.

Joe, a 27-year-old white male teacher who works out daily at the gym, begins to complain of a headache and feeling like he is coming down with the flu. The school nurse advises him to go home; rest; take ibuprofen for fever and achiness, antihistamines if needed; and to drink plenty of fluids. Joe goes home and follows the nurse’s advice. After awakening from a nap, he has a fever of 101°F orally and is complaining of a headache, nausea, and sensitivity to light. His wife brings him to the urgent care clinic because he has been talking out of his head and has begun to vomit. PSH-negative PMH; Mononucleosis at age 19 years. Consumes three to four beers per week with an occasional shot of whiskey. No tobacco or illicit drug use. Prior concussions at ages 17 and 20 years. Immunization status unknown. Physical examination reveals 103°F, mucous membrane—dry, pale, poor skin turgor. WBC 15,000, BP 100/60, HR 120. Small healing abrasion on left ankle. The primary care provider plans on admitting to the hospital for probable sepsis rule meningitis.

Related Question #1

What are the clinical manifestations of an infection?

Related Question #2

Why is this patient considered to have sepsis?

Related Question #3

Why is the primary care provider considering meningitis?

Urine and blood cultures are drawn at the hospital. A lumbar puncture is completed. CXR is done. Broad spectrum antibiotics and IV fluids are started. Acetaminophen and ibuprofen are ordered for fever greater than 101°F. His condition improves. Blood cultures are positive. All other diagnostic tests are negative.

Related Question #4

What organism would you suspect and why?

Related Question #5

What precautions to prevent infections should be taken?