1- Get MRI, then lumbar puncture
2- Oral Zithromax
To long to start doing action, is bacteriostatic you will want bactericida.
3- IV ceftriaxone w/ ampicillin
Ceftriaxone crossed and intial tx and the ampicilin is because patients over 55 are prone to also get listeria and ampicillin will cover that.
4- IV acyclovir
For virus not bacteria
There are MANY MANY Step2 questions in step1, so guys if you think is to clinical, THINK again.