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Case Study Rothia Mucilaginosa

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Case Study: Rothia Mucilaginosa

Typical Case History

Bio data:

28-year-old male, homeless, who does casual jobs.

Chief Complaints:

o Severe headache for two days

o Neck stiffness for one day

o Projectile vomiting for one day

History of presenting Illness:

o Patient reported to be well until three days ago when he started feeling generally

week. He said the headache initially was of dull ache but the intensity increased

with time. The headache was global in nature and pounding. There was associated

eye discomfort especially with bright light. Paracetamol did not relive the

headache significantly and it was worse in the morning.

o He also reported of neck stiffness. There is limited range of motion and he has to

turn his whole body check directions. There is no reliving factor.

o He also complained of projectile vomiting, which was worse in the morning.

Vomitus contained food ingested the previous night, non-bilious with no blood.

o There is hotness of the body, no history of night sweats but there history of

significant weight loss over last three months

Review of systems

There was history of a mild cough, non-productive with no associated chest pains. There

is complains of skin itching especially on the trunk region. The genital urinary and

cardiovascular systems were essentially normal.

Past Medical and Surgical History

There is no known chronic illness. No history of medical or surgical admission.

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Family Social History

He is an orphan, lives on the street. There is history of smoking, alcohol use and use of

intravenous drugs especially heroine.

Summary

A 28-year-old male presented with two-day history of severe headache associated with

photophobia, one-day history of projectile vomiting and neck stiffness. He is a homeless

uses intravenous drug.

Physical Examination

o He was sick looking, obviously wasted and unkempt. The marked oral thrush,

moderate conjunctiva and lingual pallor, and generalized lymphadenopathy. No

cyanosis, finger clubbing nor edema.

o Respiratory rate was 24 breaths per minute, temperature was 39.5 C, Heart rate

was 92 beats per minute, blood pressure was 132/ 87 mmHg and SPO2 was 98%

o On nervous exam, neck was stiff and kerning and brudnziski signs were positive.

Higher centers, cranial nerves, sensory and motor systems were normal.

o In the respiratory exam, fine crepitations were heard in both lung fields.

o Other systems were normal

Investigations and results

o Complete blood count- there was pancytopenia. Hb of 8g/dl, WBC of 2.4 * 10^6,

platelets of 150.

o Diagnostic testing and counseling for HIV virus done, patient tested positive.

o Lumbar puncture-There is increased pressure, looked turbid. There was increased

protein, reduced glucose, rothia mucilaginosa cultured. Z-N stain negative. Indian

Ink stain negative

o 2 Blood cultures obtained were with positive with rothia mucilaginosa and

negative for Cryptococcus meningitis

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Case Study: Rothia Mucilaginosa Typical Case History Bio data: 28-year-old male, homeless, who does casual jobs. Chief Complaints: o Severe headache for two days o Neck stiffness for one day o Projectile vomiting for one day History of presenting Illness: o Patient reported to be well until three days ago when he started feeling generally week. He said the headache initially was of dull ache but the intensity increased with time. The headache was global in nature and pounding. There was associated eye discomfort especially with bright light. Paracetamol did not relive the headache significantly and it was worse in the morning. o He also reported of neck stiffness. There is limited range of motion and he has to turn his whole body check directions. There is no reliving factor. o He also complained of projectile vomiting, which was worse in the morning. Vomitus contained food ingested the previous night, non-bilious with no blood. o There is hotness of the body, no history of night sweats but there history of significant weight loss over last three months Review of systems There was history of a mild cough, non-productive with no associated chest pains. There is complains of skin itching especially on the trunk region. The genital urinary and cardiovascular systems were essentially normal. Past Medical and Surgical History There is no known chronic illness. No history of medical or surgical admission. Family Social History He is an orphan, lives on the street. There is hist ...
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