Well done. Shani has all the features of bacterial meningitis.

She presented with a fever and drowsyness that led to a prolonged seizure with focal features.

Once her seizure was under control, she improved enough for you to be able to make a clear diagnosis with history, examination and investigations.

Her blood tests support a bacterial infection, and the CSF is most consistent with a bacterial meningitis. You start her on dexamethasone and ceftriaxone, and send her up to the ward.

You ask the staff to do half hourly neuro observations to pick up deterioration early and you plan to review her shortly.