A 34-year-old patient with no previous medical history presents to his doctor’s office with a complaint of stiff neck. He states that this began 5 days ago with headache and neck stiffness so bad that...

A 34-year-old patient with no previous medical history presents to his doctor’s office with a complaint of stiff neck. He states that this began 5 days ago with headache and neck stiffness so bad that he could not move it, with fevers and chills. He says that this began to improve 2 days ago and he now has some residual neck stiffness and photophobia, but otherwise feels well. His exam is otherwise unremarkable and mental status is intact. He has no fever, has stable vital signs, and results of laboratory tests show no electrolyte or blood count abnormalities. What is the most appropriate course of action?

A. Immediate IV vancomycin-cefotaxime

B. Lumbar puncture for culture and cell count

C. Head CT

D. Observation

E. Head MRI