Question

Microbiology

Meningitis

Patient B: Alice Chen, a 6-year-old female, presented to the emergency department with a 4-day history of worsening headache and a rash on her trunk. Her mother mentioned that over-the-counter medications had no effect on her headache. Alice mentioned that the bright lights of the examination room hurt her eyes and she stated that her “head hurts all over.” She also had difficulty trying to move her neck. A physical test revealed some vesicular lesions on her hands and feet. A lumbar puncture was also performed for cerebrospinal fluid analysis.

	Normal CSF ranges	Patient #A	Patient #B
Leukocytes (per mm3)			115
% Neutrophils			30
Glucose (mg/dL)			54
Protein (mg/dL)			53

Patient B has Viral Meningitis.

What specific disease does she have and why?

What is causing the viral meningitis?

Answer 1

Viral meningitis is the viral infection of the brain meninges.
Viral meningitis usually occur due to viral infection at some other part of body that crosses the blood brain barrier and infects the underlying brain.
The patient here has vescicular lesions on hand and feet. These lesions are common findings in Coxsackievirus A infection. This infection is known as hand, foot, mouth disease affecting young children.
The infection from Coxsackievirus A has spread to the brain and caused viral meningitis.