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16th August 2024
A 72-year-old man presents with confusion. He is brought with letters from the hospital
A 72-year-old man presents with confusion. He is brought with letters from the hospital, which list his current medications as being rituximab, prednisolone, lansoprazole, amlodipine, bisoprolol, and metformin.
On examination, there is photophobia and nuchal rigidity. Ceftriaxone is started.
A lumbar puncture is carried out:
| CSF appearance | Turbid | |
| Red cells | 2 | (0-10) |
| White cells | 1034 | (0-5) |
| Differential | 82% polymorphonuclear cells | |
| Protein | 1.42 | (0.15-0.45) |
| Glucose | 3.5 (serum 13.4) | (~ >60% of serum) |
Which is the single most important additional drug to add to his treatment regimen?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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