Question
A 26 years old male presented with fever and headache for 3 days. His BP is 90/60 mm Hg and examination revealed the following rash on the legs. What is the likely diagnosis
| A. |
Dengue hemorrhagic fever
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| B. |
Enteric fever
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| C. |
Meningococcus
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| D. |
Scrub typhus
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Show Answer
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Correct Answer � C
Explanation
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Ans: C. Meningococcus
History of fever and headache for 3 days with blood pressure 90/60 mm Hg and rash on the legs are suggestive of meningococcemia.
The clinical-picture given in the question i.e. meningitis with a typical purpuric rash is seen in meningococcemia due to Neisseria meningitidis, which is Gram-negative diplococci and ferments glucose and maltose.
Gram-positive cocci catalase negative, bacitracin sensitive –> Streptococcus pyogenes
Gram-positive diplococci (lanceolate), catalase negative, optochin sensitive –> Streptococcus pneumoniae
Gram-negative diplococci, ferments glucose and maltose –> Neisseria meningitidis.
Gram-negative diplococci (kidney shaped), oxidase positive –> Neisseria gonorrhoea
Early symptoms are non-specific & suggest an influenza like illness with fever, headache & myalgia accompanied by vomiting & abdominal pain.
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