Question

A 70-year-old man is brought to the emergency department after becoming drowsy and confused. He has a history of Alzheimer’s dementia. On examination he has neck stiffness and a temperature of 39.5°C. What is the most appropriate immediate management?

Accepted Answer

Start empirical intravenous antibiotics and steroids after blood cultures

Answer

Observe and await CT brain

Answer

Perform lumbar puncture immediately before antibiotics

Answer

Discharge with oral antibiotics for presumed viral illness

Answer

Prescribe oral paracetamol only

Practice question

A 70-year-old man is brought to the emergency department after becoming drowsy and confused. He has a history of Alzheimer’s dementia. On examination he has neck stiffness and a temperature of 39.5°C. What is the most appropriate immediate management?