Degenerative disk disease

Chief Complaint A 52 y/o male complains of left leg weakness, myalgia & fever. History Initially, he was diagnosed with streptococcal pharyngitis 3 days back and was taking antibiotics and then complaints of these symptoms with rashes. No complaint if any additional muscle weakness. No other past medical history. Not on any other medication. He is a chronic smoker and regular drinker. Investigations A CT scan of his spine shows degenerative disk disease of his lumbar region. A lumbar puncture performed at the outside hospital showed clear CSF with 339/cu mm of WBC (normal range: 0-5/cc mm) 14 cu mm of red blood cells, WBC differential was 17 % Segmented neutrophils (normal range: 0-6 %), 68 % lymphocytes (normal 40-80 %) and 15 % monocytes (normal range: 15-45 %), The CSF glucose, protein levels were 65mg/dL (normal range: 40-70mg/dL), 151mg/dL (normal range: 15-40mg/dL). Diagnosis What are your views?

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Csf findings suggest pyogen8c meningitis but pt is not presenting with features of meningitis H/o streptococcal pharyngitis indicates bacterial infection and correlates with csf findings Again involvement of mono appendege is lt lower limb contradictory Cbc suggest leucocytosis hence it is a c/o septicemia and involving central nervous system Better keep under observation treat symptomatically Take opinion of neurologist

Reflexes and bibinski sign also other neurological examination . MMT comparing with normal Limb can be key to differentiate UMN and LMN. If signs of UMN than CT brain can be done. Physiotherapy to prevent further degradation

? BRAIN PATHOLOGY.. ? MENINGITIS.. NEED'S.. FURTHER EVALUATION WITH EXPERTS OPINION TO CONCLUDE DIAGNOSIS AND TREATMENT..

DD viral meningitis Tumour in brain Traumatic csf repeat after48 hr

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