A woman in her 70s presented to the emergency department with fever, fluctuating cognition and headache. A detailed examination revealed neurological weakness to the lower limbs with atonia and areflexia, leading to a diagnosis of bacterial meningitis, alongside a concurrent COVID-19 infection. The patient required critical care escalation for respiratory support. After stepdown to a rehabilitation ward, she had difficulties communicating due to new aphonia, hearing loss and left third nerve palsy. The team used written communication with the patient, and with this the patient was able to signal neurological deterioration. Another neurological examination noted a different pattern of weakness to the lower limbs, along with new urinary retention, and spinal arachnoiditis was identified. After more than 10 weeks in the hospital, the patient was discharged. Throughout this case, there were multiple handovers between teams and specialties, all of which were underpinned by good communication and examination to achieve the best care.

中文翻译：

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细菌性脑膜炎和COVID-19：复杂的患者历程

70多岁的一名妇女因发烧，认知波动和头痛而出现在急诊科。一项详细检查发现，下肢有肌无力和反射障碍的神经系统无力，导致诊断为细菌性脑膜炎，并发并发COVID-19感染。该患者需要重症监护以获取呼吸支持。下岗到康复病房后，由于新的失音症，听力下降和左第三神经麻痹，她的沟通困难。该小组与患者进行了书面交流，患者因此可以发出神经衰弱的信号。另一项神经系统检查发现，下肢无力的情况有所不同，并伴有新的尿，留，并发现了脊髓型蛛网膜炎。在医院呆了十多个星期后，病人出院了。在整个案例中，团队和专长之间进行了多次交接，所有这些交接都得到了良好沟通和检查的支持，以实现最佳护理。