Bubbles on the Brain

Author: Thomas Brougham / Editor: Jason Kendall / Reviewer: Phil Delbridge / Codes: A5, CC1, R2 / Published: 15/01/2021

A 34-year-old female presented to the emergency department with a 3-day history of left ear pain, without discharge or tinnitus.

Over the last 24 hours this had progressed to a severe generalised headache with a high fever. On examination, she appeared unwell, septic and drowsy. She was tachycardic and febrile.

Observations were as follows:

HR 110, BP 98/50, RR 24, Sats 98% on air, GCS 14 (E3, V5, M6), Temp 39.3 degrees centigrade

Heart sounds were normal and the chest was clear to auscultation. Abdomen was soft.

She had no mastoid tenderness or meninigism. Neurological examination was normal.

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