An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Abstract Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis. Key Words: bacteremia, meningitis, geriatric, E. Coli, clinical, cerebrospinal, cultures, deliriu

An unusual case of Escherichia coli meningitis and bacteremia in an elderly woman presenting with intractable low back pain

Introduction: We report an unusual case of E. coli meningitis in an elderly woman who presented to the emergency room with a chief complaint of intractable low back pain. Case Description: A 67 year old woman presented to the emergency room for a chief complaint of intractable low back pain. After admission, the patient developed delirium. Blood cultures were drawn. Patient underwent a lumbar puncture which revealed purulent cerebrospinal fluid. Results of the cerebrospinal fluid and blood cultures revealed pan-sensitive E. coli. Conclusion: In the geriatric population, delayed presentation of meningitis can occur for various reasons. With the older adult population, existing co-morbidities and decline in immunologic function can mask symptoms. Clinicians caring for the elderly population need to have a high index of suspicion in the setting of subtle symptoms when it comes to diagnosing acute bacterial meningitis

Whence the interstellar magnetic field shaping the heliosphere?

Measurements of starlight polarized by aligned interstellar dust grains are used to probe the relation between the orientation of the ambient interstellar magnetic field (ISMF) and the ISMF traced by the ribbons of energetic neutral atoms discovered by the Interstellar Boundary Explorer spacecraft. We utilize polarization data, many acquired specifically for this study, to trace the configuration of the ISMF within 40 pc. A statistical analysis yields a best-fit ISMF orientation, B (magpol), aligned with Galactic coordinates l = 42 degrees, b = 49 degrees. Further analysis shows the ISMF is more orderly for "downfield" stars located over 90 degrees from B (magpol). The data subset of downfield stars yields an orientation for the nearby ISMF at ecliptic coordinates lambda, beta approximate to 219 degrees +/- 15 degrees, 43 degrees +/- 9 degrees (Galactic coordinates l, b approximate to 40 degrees, 56 degrees, +/- 17 degrees). This best-fit ISMF orientation from polarization data is close to the field direction obtained from ribbon models. This agreement suggests that the ISMF shaping the heliosphere belongs to an extended ordered magnetic field. Extended filamentary structures are found throughout the sky. A previously discovered filament traversing the heliosphere nose region, "Filament A," extends over 300 degrees of the sky, and crosses the upwind direction of interstellar dust flowing into the heliosphere. Filament A overlaps the locations of the Voyager kilohertz emissions, three quasar intraday variables, cosmic microwave background (CMB) components, and the inflow direction of interstellar grains sampled by Ulysses and Galileo. These features are likely located in the upstream outer heliosheath where ISMF drapes over the heliosphere, suggesting Filament A coincides with a dusty magnetized plasma. A filament 55 degrees long is aligned with a possible shock interface between local interstellar clouds. A dark spot in the CMB is seen within 5 degrees of the filament and within 10 degrees of the downfield ISMF direction. Two large magnetic arcs are centered on the directions of the heliotail. The overlap between CMB components and the aligned dust grains forming Filament A indicates the configuration of dust entrained in the ISMF interacting with the heliosphere provides a measurable foreground to the CMB

Jupiter is alive! HST observations of Jupiter's aurora during Juno orbits 18, 19 and 20.

The terawatts of ever-changing ultraviolet auroral emissions that are always observed with HST at both poles of Jupiter demonstrate that Jupiter's planetary system is “alive.” The characteristics of the different components of Jupiter's UV aurora provide information on the evolution of the overall state of the portion of the Jovian magnetosphere to which they connect. During the present medium-size HST campaign (HST GO-15638, cycle 26), precession of the line of apsides of Juno's orbit makes it possible to probe different regions of the magnetosphere, compared to Juno orbits during previous HST cycles. Solar wind dynamics and internal processes are known to have strong influence on Jupiter's aurora, but their relative contributions and the way they couple with each other are still under debate. Cycle 26 falls during the expected minimum of the 11-year solar activity cycle. Current measurements suggest that the solar activity is already exceptionally low, with very few solar events, like CMEs, reaching Jupiter. This provides an unprecedented opportunity to observe Jupiter's aurora during a period when its magnetosphere is mainly controlled by internal processes, therefore revealing Jupiter's natural "breathing." The present HST campaign is meant to observe Jupiter's bright FUV auroral emissions in time-tag imaging mode during Juno orbits 18 to 22 (Feb-Sep 2019). We focus on the 5-day periods prior to and during Junos perijove, when Juno is sampling the current sheet region within 60 RJ, which is expected to contain the plasma source responsible for most bright auroral components, but is in a location where these aurorae cannot be observed with Juno-UVS. We sample Jupiter's emissions at a frequency of ~1 HST visit per Jovian rotation, with typically 10 HST visits for each of the 5 Juno orbits. Here we present preliminary results inferred from HST observations and concurrent Juno in situ data, obtained during Juno orbits 18, 19 and 20

Jupiter is alive! HST observations of Jupiter's aurora during Juno orbits 18, 19 and 20. (Invited)

The terawatts of ever-changing ultraviolet auroral emissions that are always observed with HST at both poles of Jupiter demonstrate that Jupiter's planetary system is “alive.” The characteristics of the different components of Jupiter's UV aurora provide information on the evolution of the overall state of the portion of the Jovian magnetosphere to which they connect. During the present medium-size HST campaign (HST GO-15638, cycle 26), precession of the line of apsides of Juno's orbit makes it possible to probe different regions of the magnetosphere, compared to Juno orbits during previous HST cycles. Solar wind dynamics and internal processes are known to have strong influence on Jupiter's aurora, but their relative contributions and the way they couple with each other are still under debate. Cycle 26 falls during the expected minimum of the 11-year solar activity cycle. Current measurements suggest that the solar activity is already exceptionally low, with very few solar events, like CMEs, reaching Jupiter. This provides an unprecedented opportunity to observe Jupiter's aurora during a period when its magnetosphere is mainly controlled by internal processes, therefore revealing Jupiter's natural "breathing." The present HST campaign is meant to observe Jupiter's bright FUV auroral emissions in time-tag imaging mode during Juno orbits 18 to 22 (Feb-Sep 2019). We focus on the 5-day periods prior to and during Junos perijove, when Juno is sampling the current sheet region within 60 RJ, which is expected to contain the plasma source responsible for most bright auroral components, but is in a location where these aurorae cannot be observed with Juno-UVS. We sample Jupiter's emissions at a frequency of ~1 HST visit per Jovian rotation, with typically 10 HST visits for each of the 5 Juno orbits. Here we present preliminary results inferred from HST observations and concurrent Juno in situ data, obtained during Juno orbits 18, 19 and 20