Advanced Medical Life Support (AMLS)

What diagnosis is most anticipated for a university student admitted with fever, nausea, vomiting, and a flat red rash?

1. Chicken pox (varicella)

2. Meningitis

3. Encephalitis

4. H5N1 (avian) influenza

The correct answer is: Meningitis

The diagnosis of meningitis is anticipated given the presenting symptoms of fever, nausea, vomiting, and a flat red rash. Meningitis, which can be caused by viral or bacterial infections, often presents with these nonspecific symptoms, especially in younger adults such as university students, who are at higher risk due to close living conditions and social interactions. The flat red rash described might suggest meningococcal meningitis, which is a type of bacterial meningitis often caused by Neisseria meningitidis. This particular strain can lead to a petechial rash, which may start as flat red spots and progress to larger areas of discoloration. The combination of systemic symptoms like fever and gastrointestinal upset further supports the likelihood of an infectious process like meningitis. While the other conditions might present with overlapping symptoms (for instance, chicken pox can cause rash and fever, and encephalitis can result in nausea and fever), they do not typically align as closely with the classic presentation associated with meningitis in a college-aged population. Additionally, H5N1 influenza does not usually present with a rash, making it less likely in this scenario. Therefore, considering the symptoms and demographic, meningitis is the most fitting diagnosis.