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Acute Pyogenic Meningitis
Mrs. S.N:
• 67 years old
• Caucasian
• 103 lbs 5’4’’
• Smoker (1/2 pack per day for 45 years)
• vaccinated for influenza six months ago
Medical History
several severe episodes of chronic bronchitis and one episode
of pneumonia in the past two years
She has never suffered from episodes of angina or symptoms
of heart failure
denies any past history of head trauma, sinus infection,
immunodeficiency disorders, and medications that cause
immunosuppression.
Her emphysema is being managed with ipratropium bromide
Acute Pyogenic Meningitis
• Acute: Severe or Intense
• Pyogenic: involving or relating to the
production of pus
• Meningitis: inflammation of the layers of
tissue that cover the brain and spinal cord
(meninges) and of the fluid-filled space
between the meninges (subarachnoid space)
Patient Case Question 1.
What is the significance of the patient’s productive cough with
rust-colored sputum?
-Possible bacterial pneumonia being coughed up from the
lower airways.
Patient Case Question 2.
List three clinical manifestations that strongly suggest that the
patient has developed meningitis.
-Stiff neck (painful w flexion)
-Sluggishly reactive to light
-Neck shows mild anterior cervical lymphadenopathy
Patient Case Question 3. Explain the abnormalities
in the vital signs.
-Temp: 101.5 ° F
-High Blood Pressure
Patient Case Question 4.
Is the patient technically considered underweight,
overweight, obese, or does the patient have a
healthy weight based on height?
-BMI= 17.5 (Underweight)
Patient Case Question 5
Why is it appropriate for the physician to examine
the patient for a head injury?
-Nares flared, purulent discharge visible
Patient Case Question 6
List two clinical signs that are consistent with and
specific for an upper respiratory tract infection.
-Nares slightly flared, purulent discharge visible
Pharynx red with purulent post-nasal drainage
Patient Case Question 7.
Define papilledema and explain the significance
of a lack of papilledema in this patient.
Optic disc swelling that is caused by increased
intracranial pressure. No detection of
papilledema suggests that the meningitis has
been detected early.
Patient Case Question 8.
Explain the pathophysiology behind this
patient’s lymphadenopathy.
Lymph Nodes are highly organized centers of
immune cells that filter antigen from the
extracellular fluid. There is disease involving the
reticuloendothelial system, secondary to an
increase in normal lymphocytes and
macrophages in response to an antigen.
Patient Case Question 9.
What is the cause of the patient’s “significant
use of accessory muscles”?
-Emphysema
-Clear Left Lung
-Breath sounds in RML and RLL have decreased
Patient Case Question 10
What is the significance of lack of a skin rash?
-Early detection