an acute ibuprofen overdose masking a severe staphylococcus aureus meningitis: a case report

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ID: 138176
2013
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Abstract
Acute bacterial meningitis has a low incidence (3/100,000 in the United States) and yet high fatality rate (approximately 14–16%) and classically presents as a triad of fever, neck stiffness, and altered mental status. However, less than half of patients with meningitis present with this classic triad. We present the clinical course of a patient who initially presented to the emergency department after overdosing on ibuprofen for what he described as back pain secondary to mechanical injury. However, the patient's condition quickly deteriorated: he developed tachycardia, mental status changes, was intubated due to respiratory distress, and then suffered an 8-minute PEA arrest before return of spontaneous circulation was achieved. After the patient was stabilized, in addition to the nonsteroidal anti-inflammatory drug (NSAID) overdose Staphylococcus aureus meningitis, bacteremia, and pneumonia were diagnosed. We report this case to illustrate that the initial presentation of meningitis may be extremely unusual especially in the setting of NSAID overdose and the acutely decompensating patient. As the risk of adverse clinical outcomes increases with delays in appropriate antibiotic therapy, it is therefore crucial to recognize the many signs and symptoms of meningitis, typical and atypical, and quickly begin appropriate treatment.
Reference Key
smetana2013casean Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Matthew Smetana;Katy Picard;Kevin M. Boehm
Journal Ecology letters
Year 2013
DOI
10.1155/2013/603251
URL
http://dx.doi.org/10.1155/2013/603251
Keywords
critical care first aid intensive care medical emergencies

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