Answer and Explanation 4

4.  Choice B is the correct answer.  This patient has bacterial meningitis.  The current standard of care is to start the patient on Rocephin 2 grams, Vancomycin 1 gram, and Acyclovir IV until the cultures come back or gram stain is available.  Patients with viral meningitis typically have low WBC and normal glucose.  Patients with viral meningitis only need to be admitted for symptomatic management or if they have comorbid disorders. These results are definitely not normal.  Technically any WBC over 5 in the CSF is considered abnormal.