Brief Answer:
There are Several in fact.... as following..

Detailed Answer:
Hello xxxxxxxxxxxxxxxx, Welcome to HCM,

From the detailed history you've given, there are several possibilities and i'm going to let you know one by one sequentially..

First of all, Lupron, in male patient's, administered mainly due to prostate cancer..

Yes, those hot flashes,swelling,pain were all after effects of it, but as it seems with the fever and other symptoms, the injection site most likely got infected..

And he seems to be diagnosed with Meningitis(bacterial) of brain that's why he was put on Ceftriaxone and Vancomycin intravenous antibiotics therapy , but dear let me inform you that in a diagnosed case of bacterial meningitis, it should not to be stopped after 5 days in the first place (unless there was another diagnosis made by the Neurologists, which is very unlikely as per your description)..

He was throwing up again,talking irrelevant, getting unbalanced were all signs of relapse of the meningitis and this time there was also intra-cerebral edema(swelling in side the brain) also, for which he was given those doses of steroids with gradual tapering..

Brain biopsy was particularly done to rule out any metastasis (Secondaries as we say) from some other region of primary (?Prostate)..

So the first step to do now is a repeat Cat Scan of the brain to find out the present status, and if there's any underlying hydrocephalus(Swelling of the cisterns in side brain) then drain it(at first externally, then later on internally, if required)..

If this has ruled out then next step is to perform a repeat Lumbar puncture to get a fresh sample of CSF and analyse as well as send for culture sensitivity(both bacterial as well as viral)..

Consider putting him on higher generation of antibiotics as there's a high suspicion of resistant organisms this time..

Rest all supportive therapy should go on as per needed..

If Possible, Please provide the detailed hospital course and treatment summary so that I can look in depth, and clarify them to you..

You can upload them at the reports section or alternatively you can even e-mail them to YYYY@YYYY and keep the subject as ATTN:Dr XXXXXXX and i'll get them..


So i'll be waiting for the further details from you so that i can guide you more specifically..


Take Care
Kind Regards

---