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
Cevap
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.
Adım Adım Çözüm
Anahtar Kavram
Empiric and targeted antimicrobial management of central nervous system infections is heavily dependent on patient age, immune status, characteristic neuroimaging findings, and exposure history.
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