A 26-year-old woman presented to the emergency department with complaints of headache and severe back pain in the thoracic region. Medical history: Bronchial asthma and bacterial angina for the last three weeks Signs & symptoms Thoracic pain lasted for three days with accelerated inhalation. The pain radiated to the left upper extremity and pericardial region and was followed by elevated fever. She was diagnosed with intercostal neuralgia before admission and was treated with steroidal analgesics.
The woman was nervous and tearful during the clinical evaluation. She exhibited meningeal pathological symptoms, neck rigidity, and Kernig symptoms bilaterally. Laboratory findings: Elevated serum C-reactive protein (128 mg/L) CT scan (head): Left maxillary sinus inflammatory exudate Metallic orthodontic braces were present. Laboratory CSF exam: Elevated pleocytosis (36/mm3) and protein level…
