[45F] Experiencing severe headache, high fever, and back pain

Patient Description

A 45-year-old female is suffering from a severe headache that started suddenly and is exacerbated by movement, accompanied by a high fever of approximately 103 degrees Fahrenheit, persistent for two days. The patient also reports visual disturbances, slight dizziness, and mild neck stiffness, as well as confusion and difficulty staying awake. Additionally, the patient has been experiencing a continuous ache in the mid-back since the previous night, rated as a 6 out of 10 in severity. The patient has been self-medicating with 500 mg of Tylenol and 200 mg of Ibuprofen every 4-6 hours with only temporary relief. The patient has a known allergy to penicillin and is not on any other medications or supplements. There is no recent history of injury, vaccination for infections such as meningitis or pneumococcus, and no known recent exposure to infectious diseases.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possibilities:

  • Meningitis: This is an infection of the membranes surrounding your brain and spinal cord. Symptoms can include severe headache, fever, confusion, neck stiffness, and sensitivity to light. Given the severity of your symptoms, this is a possibility that should be evaluated urgently.

    • Treatment typically involves antibiotics and sometimes antiviral medications. Hospitalization is often required.

  • Encephalitis: This is inflammation of the brain, often due to an infection. Symptoms can be similar to meningitis and can also include seizures, though you have not reported any.

    • Treatment usually involves antiviral medications and supportive care, such as pain relievers and fever reducers, in a hospital setting.

  • Severe Migraine: Migraines can cause severe, debilitating headaches and can sometimes be accompanied by other symptoms such as sensitivity to light and sound, nausea, and vomiting. However, your high fever and confusion are not typical of a migraine.

    • Treatment usually involves medications to relieve symptoms and, in some cases, preventive medications.

Please note that these are possibilities based on the symptoms you've described and not a definitive diagnosis. It's crucial to seek immediate medical attention given the severity of your symptoms.

What you can do

Given the severity of your symptoms, especially the severe headache, high fever, and changes in mental status, it's important to seek medical attention immediately. Please go to the nearest emergency department or call for an ambulance if you are unable to transport yourself safely.

What you should look out for

Watch out for any worsening of your symptoms, such as:

  • Increasing confusion or difficulty staying awake
  • Seizures
  • Severe neck stiffness or pain when bending your neck forward
  • Any new symptoms

Remember, it's important to get medical help right away. Please don't delay seeking care.

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9 mo ago

People Also Ask

What are the common symptoms of meningitis?

Common symptoms of meningitis include severe headache, high fever, neck stiffness, confusion, sensitivity to light, and sometimes nausea or vomiting. It's important to seek medical attention if you experience these symptoms.

How is encephalitis different from meningitis?

Encephalitis is inflammation of the brain, often due to an infection, and can cause symptoms similar to meningitis, such as headache, fever, and confusion. However, encephalitis can also lead to seizures and more pronounced neurological symptoms. Both conditions require urgent medical evaluation.

Can a severe migraine cause a high fever and confusion?

Severe migraines can cause intense headaches and sensitivity to light and sound, but they typically do not cause high fever or confusion. If you experience these symptoms, it may indicate a more serious condition, and you should seek medical attention.

What should I do if I experience sudden severe headaches and high fever?

If you experience sudden severe headaches and a high fever, especially with confusion or neck stiffness, it's crucial to seek immediate medical attention. These symptoms could indicate a serious condition like meningitis or encephalitis, which require prompt treatment.

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