Rule Out / Past cases / Bacterial meningitis
Rule Out case #6 · ModerateBacterial meningitis: a six-clue practice case
Read the clues in order and name the diagnosis as early as you can. Clues move from the patient’s story to the classic findings.
Play it as a game firstGuess before each clue unlocks, then share your score.The clues
Clue 1: A 19-year-old who lives in a college dorm has a severe headache.
Clue 2: It came on over the past day, along with a high fever.
Clue 3: Bright light hurts their eyes, and their neck is too stiff to touch chin to chest.
Clue 4: They are becoming confused.
Clue 5: A purple rash that does not fade when pressed appears on their legs.
Clue 6: Spinal fluid is cloudy, with many neutrophils, low glucose and high protein.
Show the diagnosis and takeaways
What gives it away
- Fever, neck stiffness and altered mental status are the classic triad, though all three are not always present.
- A non-blanching purple rash in a young adult suggests meningococcus, which spreads in dorms.
- Antibiotics must start right away, even before the spinal tap if there will be any delay.
Ran as Rule Out #6 (Friday, October 23, 2026).
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