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35 yo M presents with sudden severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity most likely dx?

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Final answer:

The symptoms presented - severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity - suggest a likely diagnosis of bacterial meningitis, which is a medical emergency requiring immediate treatment.

Step-by-step explanation:

The symptoms described in the scenario suggest a strong likelihood of a diagnosis of meningitis. Meningitis is the inflammation of the protective membranes covering the brain and spinal cord, known as the meninges. This condition can present with a rapid onset of symptoms such as severe headache, vomiting, confusion, nuchal rigidity (stiff neck), and focal neurological deficits like hemiplegia (paralysis of one side of the body).

Symptoms of meningitis can mimic other medical conditions, but the presence of a stiff neck, along with a severe headache, and altered mental status, such as confusion or reduced alertness, are hallmarks of this serious infection. The fact that the question specifically mentions sudden severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity points toward bacterial meningitis as a probable diagnosis.

Additional tests, such as a lumbar puncture for cerebrospinal fluid analysis, are critical for confirming the diagnosis and should be performed promptly to begin appropriate treatment. Bacterial meningitis is a medical emergency that requires immediate intervention with antibiotics to prevent complications like brain damage or death.

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