A 35 year-old woman presented with a history of fever, headache, vomiting and photophobia the day after the fullterm uncomplicated normal vaginal delivery of her second child. On examination, she was drowsy, had neck stiffness and positive Kernig's sign. Investigations showed marked neutrophil leucocytosis with high erythrocyte sedimentation rate (ESR). Cerebrospinal fluid (CSF) was 3 markedly turbid with polymorphs of 534 /mm , 3 3 lymphocytes of 3/mm , red cells of 20/mm , protein of 0.65g/L CSF glucose of 3.7 mmol/L (with a simultaneous random blood sugar of 6.8 mmol/L). CSF culture was sterile.

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