03 Feb 2026

Episode 219: Meningitis 2.0

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Core EM - Emergency Medicine Podcast

Meningitis, particularly its high morbidity and mortality, is the central topic, explored through a case presented by Dr. Sarah Fetterolf. The discussion begins with a 36-year-old man exhibiting generalized weakness, fevers, and altered mental status, eventually diagnosed with strep pneumo meningitis. Key insights include the importance of recognizing the classic triad of fever, nuchal rigidity, and altered mental status, though its sensitivity is low. The conversation emphasizes early administration of antibiotics and antivirals, even before lumbar puncture, to reduce mortality. The rare and dangerous Osler's triad, involving pneumonia, endocarditis, and meningitis, is highlighted, noting its high mortality rate, especially with CNS involvement, and association with risk factors like asplenia.

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