Match each clinical presentation of a central nervous system infection (or related exposure) to the most appropriate targeted antimicrobial therapy or prophylaxis regimen.
- A 74-year-old man presenting with acute fever, nuchal rigidity, and altered mental status; cerebrospinal fluid analysis shows marked neutrophilic pleocytosis.Intravenous ceftriaxone, vancomycin, and ampicillin
- A 28-year-old woman presenting with acute fever, headache, severe behavioral changes, and focal seizures; neuroimaging reveals right temporal lobe edema.Intravenous acyclovir
- A 19-year-old asymptomatic college student who is the roommate of a patient recently hospitalized with confirmed Neisseria meningitidis meningitis.Oral ciprofloxacin or oral rifampin
- A 45-year-old man with advanced HIV presenting with subacute headache and an opening pressure of 350 mm H2O on lumbar puncture; cerebrospinal fluid testing is positive for an encapsulated yeast.Intravenous liposomal amphotericin B and oral flucytosine
Answer
Match the older adult with meningitis to ceftriaxone, vancomycin, and ampicillin; the temporal lobe encephalitis to acyclovir; the meningococcal contact to ciprofloxacin or rifampin; and the HIV patient with cryptococcal meningitis to amphotericin B and flucytosine.
Each pair correctly matches a classic central nervous system infection presentation (or related exposure) with its definitive first-line therapy or prophylaxis according to current infectious disease guidelines.
Step-by-Step Solution
Key Concept
Empiric and targeted antimicrobial management of central nervous system infections is heavily dependent on patient age, immune status, characteristic neuroimaging findings, and exposure history.
Estimated Time:1m 30s