Question

A 28-year-old with new-onset severe headache, photophobia, nuchal rigidity, fever 39.2°C (102.6°F). BP 124/76, HR 104. No focal deficits. What is the immediate next step?

Accepted Answer

Start empiric IV ceftriaxone + vancomycin after blood cultures

Answer

CT head before antibiotics in all cases

Answer

Lumbar puncture before any antibiotics regardless of status

Answer

Start steroids only and observe

Answer

Discharge with oral antibiotics

Practice question

A 28-year-old with new-onset severe headache, photophobia, nuchal rigidity, fever 39.2°C (102.6°F). BP 124/76, HR 104. No focal deficits. What is the immediate next step?