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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Headache, Back Pain With Diarrhea And Vomitings Be Sign Of Spinal Meningitis?

My sister is experiencing seveere head ached and back pain. Last night she was in the energency room all day with the doctors giving her IV s because along wuth the head aches she was vomiting and experiencing diarhhea. She is suppose to have a spinal tap done on Thursday because of the swelling of her ocular nerve. I am concerned about her constant headaches and the fact that the doctors are looking at the spinal fluid from the test. The MRI of her brain showed no tumors and the CAT scan or what ever est they did today showed no irregularities of her heart since her heart rate was elevated today. Could my sister be experiencing early signs of spinal menegitis and if the doctors are doing a spinal tap want they be looking for bacteria in the fluid. More importantly shouldn t they place a rush on this test because I know spinal menegitis can be lethal and if gone untreated a patient could succumb with in a 24 hour spand of time.
Mon, 16 Jan 2017
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's  Response
One of the most worrisome differential diagnosis of headache with fever is meningitis. You did not mention fever, but if she has fever or any signs of infection in her blood analysis (leukocytosis, high CRP) and there is no other origin found (normal chest xray, normal urinalysis) a spinal tap is definately indicated to rule our meningitis or encephalitis. To adress your last sentence: Your sister would only be in immedate danger if she is obtunded, confused or is not able to flex her head anymore from pain. The tap can be deferred for a few hours, if that is not the case.
Headache is also a common nonspecific symptom with accompanies a GI-infection, which does seem more likely from what you told me.
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Severe Headache, Back Pain With Diarrhea And Vomitings Be Sign Of Spinal Meningitis?

One of the most worrisome differential diagnosis of headache with fever is meningitis. You did not mention fever, but if she has fever or any signs of infection in her blood analysis (leukocytosis, high CRP) and there is no other origin found (normal chest xray, normal urinalysis) a spinal tap is definately indicated to rule our meningitis or encephalitis. To adress your last sentence: Your sister would only be in immedate danger if she is obtunded, confused or is not able to flex her head anymore from pain. The tap can be deferred for a few hours, if that is not the case. Headache is also a common nonspecific symptom with accompanies a GI-infection, which does seem more likely from what you told me.