Acute Bacterial Meningitis

A 37-year-old man presented to the emergency room with complaint of fever of 4 days duration. The fever was continuous, reaching a maximum of 102° Fahrenheit associated with chills but without rigor. There was nausea along with a severe headache which was sudden in onset, diffuse, constant, and exaggerated by head movement. The day before presenting to hospital, he had 5 episodes of vomiting. In the emergency room, he still had projectile vomiting. The patient was drowsy and history was taken from one of his family members. The patient was a farmer by occupation and denied any high-risk sexual behavior, blood transfusion, or intravenous blood transfusion. He also denied any past history of diabetes mellitus, tuberculosis, seizure, weakness of any parts of the body, or trauma.