Question 285 · LEK · Meningitis
A 38-year-old patient is admitted to the hospital because of headache, confusion, right hemiparesis and dysphasia lasting 24 hours. Additionally herpes is present, temperature 38.6 Celsius, nuchal rigidity 3 fingers. Cerebrospinal fluid examination shows: pleocytosis 250 leukocytes/mm³ - 90% of them are lymphocytes, protein level 70 mg/dL, glucose level 60 mg/dL (serum glucose level 85 mg/dL). Head MRI shows enhanced signal FLAIR in the medial left temporal lobe. Until you get microbiology and PCR tests, the first-choice drug against the most probable etiological factor in this situation is:
- A. acyclovir.
- B. cephalosporin III generation e.g. ceftriaxone.
- C. steroids.
- D. 20% mannitol.
- E. amoxicillin and clavulanic acid.
Hint
Fever, focal deficits, lymphocytic CSF with normal glucose and temporal lobe involvement point to one virus with a specific antiviral drug.
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