13th August 2024

A 29-year-old female is brought into A&E by her housemate. She has been feeling unwell

A 29-year-old female is brought into A&E by her housemate. She has been feeling unwell for the last 4 days with a headache, photophobia and lethargy. On assessment, her observations are: HR 90 bpm, BP 127/80 mmHg, temperature 37.4 degrees Celsius, RR 15/minute, sats 100%. Blood tests show a CRP of 42 and a glucose of 5. Her CT head is reported as normal. Her neurological examination reveals nuchal rigidity. She also reports painful bumps in the genital area for the last 2 weeks and there is palpable lymphadenopathy in the groin. She reports having unprotected sex with a new partner who she met 2 months ago.

A lumbar puncture is performed, which shows:

There is no growth in the CSF or blood cultures after 48 hours.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.