My husband is being treated for a bacterial intestinal infection that is most likely shigellosis. He is exhibiting CNS symptoms that mimic meningismus (stiff neck, intracranial pressure). His temp is normal, HR is 78, BP is 115/80. Pupillary response is normal. He is able to flex his chin to his chest and is not photosensitive. Ive read that this is side effect of shigella exotoxins. Should he go to the ER?
Hi and thanks for the query, Stiff neck and intracranial hypertension are very concerning symptoms. This deserves a formal exclusion of a bacterial meningitis. Under close supervision and monitoring, a lumbar tap might be useful to make a proper diagnosis of bacterial meningitis. Late diagnosis and treatment could complicate outcome. Blood culture and antibiotic sensitivity tests could be helpful. Kind regards