Reference no: EM133815894

Question 

Admission diagnosis is cold, high fever, vomiting. Discharge diagnosis is meningitis. History of present illness: this is the first admission of a 4-month old female. Five days before admission, patient developed mild cold. One day before admission, high fever was noticed. The fever has persisted. Sleepiness has been noted by the mother. The patient was seen and admission was advised. Significant past history indicates this child was born at St. Joseph's Hospital. The patient is a product of a gravita 10, para 9, normal, uncomplicated pregnancy. Delivery was spontaneous. No neonatal complications. Birth weight was 8 lbs 9 ounces. The initial family history was negative. During this admission it was learned that one daughter had sickle cell anemia and required frequent transfusions. She is now dead from an auto-accident. Growth and development of the patient was normal. Physical examination: Temperature 102 degrees Fahrenheit. Pulse 100. Respiration rate 75. Weight: 15 pounds. Anterior front canal was slightly bulging. Throat was hyperemic. No exudates. Neck was rigid and stiff. Chest showed slight intercasal retractions. Lungs revealed bilateral bronchi. No rhalls heard. Abdomen showed no organomegaly. Umbilical hernia present. Extremities were slightly hypertonic. Neurological exam showed positive ? positive ? and positive? Signs.