Meningitis: The Daily PANCE Blueprint
Which of the following is the most common cause of bacterial meningitis in adults?
A. Neisseria meningitidis
B. Streptococcus pneumoniae
C. Listeria monocytogenes
D. Haemophilus influenzae
E. Escherichia coli
Answer and topic summary
The answer is B. Streptococcus pneumoniae
Streptococcus pneumoniae is the most common cause of bacterial meningitis in adults and elderly patients. It presents with fever, headache, neck stiffness, altered mental status, and photophobia. Diagnosis is confirmed by lumbar puncture showing elevated WBCs, decreased glucose, and increased protein. Empiric treatment includes IV ceftriaxone, vancomycin, and dexamethasone.
Incorrect Answers:
- Neisseria meningitidis: More common in young adults, military recruits, and college dorm residents; often presents with petechial rash.
- Listeria monocytogenes: More common in neonates, immunocompromised patients, and elderly; treated with ampicillin.
- Haemophilus influenzae: Previously a major cause, but incidence has declined due to Hib vaccination.
- Escherichia coli: More common in neonatal meningitis and often associated with birth canal transmission.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ ⇒
Also covered as part of the Family Medicine, Emergency Medicine, Internal Medicine, and Pediatric EOR Topic Lists
