University-induced Headaches

🗒️ Question 

A 22 year old female university student presents to the Emergency Department with a severe headache, photophobia, neck stiffness and a high fever.

On examination, there is a positive Brudzinski sign and a petechial rash on her lower extremities. Her vital signs include a temperature of 39.5°C, heart rate of 110 bpm, blood pressure of 90/60 mmHg and a respiratory rate of 22 breaths per minute. She appears drowsy but responds to verbal stimuli.

A lumbar puncture is performed, and the cerebrospinal fluid (CSF) shows an increased white cell count predominantly of neutrophils, elevated protein and low glucose levels.

What is the most likely causative organism?

(A) Neisseria meningitidis
(B) Streptococcus pneumoniae
(C) Haemophilus influenzae type b
(D) Listeria monocytogenes
(E) Mycobacterium tuberculosis