Fatal Case of Non-culturable Meningitis with Pulmonary Embolism

A 16 year old girl with past history of anxiety, depression, and anorexia presents with malaise, fatigue, severe neck stiffness and pain. She also had abdominal pain with non-bilious vomiting which had been worsening for 1 week. Three days earlier she was admitted in our hospital with mono-like symptoms, enlarged liver and spleen, as well as lingual nerve palsy. After consulting with Pediatric Neurology she was treated with steroids and discharged home. However, after discharge she continued to have severe malaise and diffuse body aches, especially in the right upper shoulder and neck. She also had an occipital headache and right sided abdominal pain. During this period she was afebrile.