29th April 2024

A 22-year-old university student presents to the emergency department with a two-day history of severe headache and fever.

A 22-year-old university student presents to the emergency department with a two-day history of severe headache and fever. She also reports a recent upper respiratory tract infection. On examination, she has a temperature of 38.7°C and shows positive Brudzinski and Kernig signs. Her neurological examination is otherwise normal. A lumbar puncture is performed, revealing cloudy cerebrospinal fluid with increased white cell count, predominantly neutrophils.

Which is the most likely diagnosis?