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Arch Neurol. 2001;58:820.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A previously healthy 35-year-old man presented with altered mental status. One day prior to admission, the patient fell and landed on his back but sustained no noticeable injury. He complained of a sudden onset of severe headache associated with photophobia and nuchal rigidity.

The patient's temperature was 101.2° C. He was agitated and moved all 4 extremities spontaneously, but did not follow commands. Nuchal rigidity was prominent. The remainder of the physical examination findings were unremarkable. A lumbar puncture revealed purulent liquid with 26.63 x 10⁹/L of white blood cells (7% bands, 92% segmented neutrophils, 1% monocytes), undetectable glucose, and 10.56 g/L of protein. Gram stain findings showed gram-positive cocci. The cerebrospinal fluid culture grew group B streptococcus (Streptococcus agalactiae); the patient's antibiotic regimen was changed to ampicillin and gentamicin, then to penicillin G after sensitivities returned. A midline tuft of hair and area of bluish discoloration . . . [Full Text of this Article]

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