Description
A twenty-four years old male was admitted to the psychiatric ward with a diagnosis of schizophrenia and treatment was started immediately. His condition was improving but on the day 4 of admission he became pyrexial. He complained about difficulty in swallowing. On examination the following positive findings were obtained: temperature was 40OC with appropriately raised pulse rate and there was marked neck stiffness. Other systemic examinations detected no abnormality but proper neurological assessment was difficult due to poor co-operation of the patient. Attempts to examine the throat failed due to the same reason. Provisional diagnosis of meningitis was made and a lumbar puncture was performed after ensuring there was no papilloedema.
