Free BCEN Certified Emergency Nurse (CEN) Practice Question

The patient's clinical presentation and lumbar puncture results are indicative of bacterial meningitis. These findings are typical, as bacterial meningitis commonly presents with high fever, headache, and neck stiffness (also known as nuchal rigidity). The cerebrospinal fluid in bacterial meningitis often shows a high white blood cell count (pleocytosis), decreased glucose (due to bacterial consumption), and increased protein (due to inflammatory response). Viral meningitis, though also presenting with fever and headache, typically results in lymphocytic pleocytosis with normal or slightly elevated protein levels and normal glucose levels in the CSF. Fungal meningitis generally has a more insidious onset and may present with similar CSF findings to bacterial meningitis, but is less common and is often associated with immunocompromised states. Encephalitis primarily affects the brain parenchyma and may be caused by herpes simplex virus; it often presents with altered mental status, focal neurological deficits, and seizures, in addition to fever and headache.