ABSTRACT
This chapter presents a case study of a 20-year-old student who is brought to the Emergency Department after his room-mate noticed that he did not attend a class tutorial and found him in a semi-conscious state. This patient presents with fever, reduced level of consciousness and evidence of meningism on examination, which are classic for bacterial meningitis. This is a condition that is fatal unless promptly recognised and treated. The two most common pathogens causing bacterial meningitis are Streptococcus pneumoniae and Neisseria meningitidis. Meningococcal meningitis has a high mortality, with 10"-15" of patients dying of the disease despite appropriate therapy. Therefore, the role of the Emergency Department physician is crucial in initiating treatment. A key aspect of managing this patient involves gathering a history of contact exposure as antibiotic prophylaxis is required in close contacts. Anyone with prolonged and close contact with the patient as well as those directly exposed to the patient's oral secretions will need chemoprophylaxis.
