History of Present Illness:
A 30-ish-year-old male with a history of headaches but no migraine presents with 1 day of bitemporal headache and vomiting and photophobia without fever. HA has been gradually worsening since yesterday. He had 2 similar headaches in his life. He denies any weakness numbness or change in vision but has had a little bit of cough sore throat chills but no fever and photophobia.
Vital Signs & Physical Exam:
Vital signs are normal except for elevated BP. Physical exam is also normal except for a positive jolt sign and the finding below
What is the most likely diagnosis?
- A) Migraine
- B) Meningitis
- C) Monoxide
- D) Mass
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QUIZ ANSWER: What is the most likely diagnosis?
- A) Migraine – can cause photophobia, but typically not this severe
- B) Meningitis – CORRECT. In a patient with symptoms concerning for meningitis if the photophobia is severe enough that they want to keep a blanket over their head and or their eyes closed most of the time, strongly consider an LP
- C) Monoxide
- D) Mass
1-Minute Consult on this topic: Click HERE and scroll.
CASE CONCLUSION: CSF had normal protein and glucose but 40 WBC and 160 RBC