A 23-year-old female presented to the ER of a small community hospital at 4 AM with complaints of fever, headache, neck pain, and vomiting. A day earlier to the presentation, she was assessed with fever, left earache, sore throat, and was prescribed oral amoxicillin 250 mg/8 hours after being diagnosed with otitis media. Physical examination of the patient on the day of presentation to the ED revealed the following: Vitals: oral temperature 37.7 o C, pulse 132/min, and blood pressure 124/72 mmHg. A red tympanic membrane in the left ear.
Pain with neck flexion; however, no neck stiffness. Subsequently, the patient was put under conservative management with intravenous fluids, an anti-emetic, and analgesics. Blood culture was sent for evaluation. Subsequently, the ER physician consulted an internist over a phone call for the need of conducting a lumbar puncture (LP) to rule out bacterial…
