Question

A 30-year-old dairy farmer was in good health until the day prior to admission, when he felt chilled and feverish. He developed nausea, vomiting, diarrhea, and lower abdominal discomfort and presented to the emergency room, where he was noted to be lethargic. His vital signs included, temperature of 40°C. His physical examination was remarkable for lower abdominal tenderness to palpation bilaterally. A rectal examination revealed occult blood in the stool the patient was lethargic but had no focal neurological deficits. Of note, his 3-year-old child had been discharged from the hospital 2 days previously with a similar history. The patient underwent a lumbar puncture because of his altered mental status and fever. Laboratory studies of cerebrospinal fluid (CSF) were within normal limits, and a bacterial culture of CSF was negative. A stool examination for fecal leukocytes was positive, and stool culture was diagnostic. Biochemical examination of the organism revealed it to be a lactose nonfermenter on MacConkey agar, H2S negative, urea negative, and nonmotile at both 25 and 37°C. 1. On the basis of the biochemical reactions, which organism do you think this is? 2. Did the person have meningitis? Explain your answer.

Answer 1

Answer:

Negative.

Explanation:

The CSF test was within normal limits.