Brief Answer:
Need work up and DDs assessment

Detailed Answer:
Thank you for asking!
i want you to know that meningitis classic triad presentation of a meningeal inflammation of Fever, neck stiffness and headaches.
Usually viral meningitis have a history of preceding systemic symptoms (eg, myalgias, fatigue, or anorexia)and symptoms of headaches , vomiting and nausea, neck stiffness and swelling , with positive brudzinski’s sign and definitely a fever.
you just have headaches That does not complete the triad for a bacterial meningitis. I will guide you regarding its management to the best of my abilities and help you understand what is going on.
apart from the classic triad of fever, neck stiffness and headaches following symptoms are usually followed by meningitis. remember not all of them may be present only a few can make and confirm the diagnosis.

Nausea
Vomiting
Photalgia (photophobia) – Discomfort when the patient looks into bright lights
Sleepiness
Confusion
Irritability
Delirium
Coma
Now before confirming the etiology and specific cause behind this meningitis and whether it is meningitis or not we need to run some labs and work up which you are going to do as i tell you.
1) Blood work
a- A complete blood count with differentials, if the leukocytes are higher and left shited then it will confirm the acute bacterial meningitis. If lymphocytes predominate then it would be viral or a tuberculous, as you are in low TB zone odds for viral one will be high, but here it seems bacterial so leukocytes are gonna show up high.
b- Serum electrolytes, to determine dehydration or syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
c-Serum glucose (which will be compared with the CSF glucose) if csf glucose less than 2/ 3 rd of serum one the odds for bacterial will be confirmed.
d-Blood urea nitrogen (BUN) or creatinine and liver profile, to assess organ function and adjust antibiotic dosing
2)Lumbar Puncture and CSF Analysis
it will be done for the assessment of opening punctures, glucose levels, leukocytes levels, protein levels, and microorganisms via culture and sensitivity and the final confirmation of the cause will be achieved. Whether it is viral, bacterial or aseptic or cryptococcal or septic will be confirmed. So must to be done test but make sure the bleeding profile is not deranged as that might lead to complications like hematomas and hemorrhages, so simple PT APTT and platelets must be looked at before doing it.
3) Antigen testing and culturing
Latex agglutination or counterimmunoelectrophoresis (CIE) of blood, urine, and CSF and PCR techniques are some of the methods need to be devised for confirming the organism.
4) Serum Procalcitonin
It is must done test these days as it differentiates bacterial from septic and aseptic meningitis.
5) Neuro Imaging like CT and MRI does not help the diagnosis and should not be wasted time on. Just to be reserved for complications if any ( GOD FORBID).
Miss XXXXXXX i want you to visit ER as your kid will need admission and IV antibiotics, steroids, antivirals, diuretics and osmotic agents if need be and anti convulsants.
Don’t worry it is easily treatable and odds for cure increase the earlier it gets managed.all you need is some labs and prompt treatment as per the causative agents like antivirals in viral, antibiotics in bacterial cases and close monitoring of intracranial pressures and prophylaxis of anticonvulsants to prevent any seizure as a complication.
The only step is to confirm the cause of it and then treatment is simple. Don’t worry and don’t panic. it is common and needs simple management .You just need to visit ER and they will take care of you.
Remember it might not be meningitis. COuld be a simple migraine. But lets just be on the safer road and get some labs to rule out that.
I hope it helps. take good care and don't forget to close the discussion please.
Regards
S Khan

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