A one-week-old baby develops nuchal rigidity and fever. A lumbar puncture is performed and the cerebrospinal fluid demonstrates large numbers of neutrophils. Which of the following is the most likely causative agent?: (A) Coxsackievirus, (B) Escherichia coli, (C) Herpes virus, (D) Mycobacterium tuberculosis
Answer is B. The nuchal rigidity (stiff neck) suggest meningitis. Numerous neutrophils in the cerebrospinal fluid suggests a bacterial pathogen. The best answer of those listed is Escherichia coli, which is normally a gut organism, but can infect neonates who acquire the organism during passage through the bih canal. Coxsackievirus is a cause of acute lymphocytic meningitis. Herpes virus is a cause of lymphocytic meningitis. Mycobacterium tuberculosis is a cause of chronic meningitis.