 You're working in the emergency department today. Your next patient is a 22-year-old female who is complaining of a headache. She is accompanied by her sister. Her headache started about three days ago. It was gradual in onset, bifrontal, and in her neck. She described it as a dull ache that started off at 2 out of 10, and now is a 6 out of 10. She is unable to sleep due to the headache. She has taken some over-the-counter energetics, but they did not work. She thinks she might have had a fever the night before. She has no past medical history. She has not recently traveled. She lives with her sister, and two of her friends have the flu. On examination, she has a fever. Her heart rate is 110. Blood pressure is 95 over 60. Oxygen saturation is 99% in rim air. She looks uncomfortable. When you examine her, she points to her posterior neck as being tender, and it was difficult for her to flex her neck. She has no focal neurological signs and no papillodema. Her kernic and Brzezinski signs were both negative. She has no rash or joint pain. The rest of her examination is non-contributory. You discuss this case with your staff, and you are most worried about her having meningitis. You put the patient on a monitored bed and give her intravenous fluid bolus. You also started her on IV antibiotics. You also give her some pain medication for a headache. Her blood pressure comes up, and her heart rate comes down with the fluid bolus. You and your staff physician performed a lumbar puncture on this patient, and send the CSF fluid for analysis. The CSF result shows high white blood cell count, with predominantly neutrophils, there are no red blood cells, there is also high protein and low glucose in the CSF, consistent with a picture of a bacterial meningitis. The gram stain is pending. You call the inpatient service to take over the care of this patient. You also ask your sister to register as a patient to describe her with prophylactic antibiotics.