DAILY NURSE GAMES

Diagnose It Answer — April 3, 2026

PUZZLE #3
TODAY'S DIAGNOSIS
Meningitis

ALL CLUES

Clue 1Chief Complaint

22-year-old college student brought in by roommate with severe headache described as 'the worst of my life,' fever, and neck stiffness.

Clue 2History

Symptoms developed rapidly over 6 hours. Lives in a college dormitory. No recent travel. Vaccination history unknown.

Clue 3Vitals

Temp 39.8°C, HR 124, BP 88/54, RR 22. Patient is photophobic and phonophobic. GCS 13.

Clue 4Assessment

Positive Kernig's sign and Brudzinski's sign. Non-blanching petechial rash noted on trunk and lower extremities.

Clue 5Labs

WBC 22,000 with left shift. LP shows cloudy CSF, elevated protein, low glucose, WBC 850 (predominantly neutrophils). Gram stain pending.

CLINICAL NOTE

Bacterial meningitis is a life-threatening infection of the meninges requiring immediate antibiotic administration — nurses must not delay treatment waiting for LP results if the patient is deteriorating. The classic triad is fever, neck stiffness, and altered mental status, with a CSF WBC count above 1,000 cells/mcL strongly suggesting bacterial etiology. Non-blanching petechiae suggest meningococcal disease and indicate septicemia; nursing priority includes droplet isolation precautions and close neurological monitoring.

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