This is a case of streptococcus pneumoniae meningitis in an immunocompromised patient.This case discusses the presentation, management, and complications of a 57-year-old female with past medical hist..
This is a case of streptococcus pneumoniae meningitis in an immunocompromised patient.This case discusses the presentation, management, and complications of a 57-year-old female with past medical history significant for Hodgkin's lymphoma in remission and rheumatoid arthritis on immunosuppressive therapy who presented to the emergency department with altered mental status.In the emergency department patient was found to have a fever of39.5 ° C, tachycardia 140s , and hypotensive at 73/40. Laboratory studies were significant for leukocytosis of 24 with a lactic acid of 4. Chest x-ray was negative for pneumonia.CT head was negative for acute intracranial abnormality. Patient was empirically started on antibiotic coverage for possible meningitis that included vancomycin, ceftriaxone, ampicillin, and acyclovir. Lumbar puncture was performed and spinal fluid was positive for 879 white blood cells, protein 591, lactic acid 16.2, and glucose