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Meningococcal Meningitis – Immediate Treatment — SCE Neurology MCQ

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HardCNS InfectionsMeningococcal Meningitis – Immediate TreatmentSCE Neurology

A 70-year-old with chronic kidney disease and diabetes presents with suspected bacterial meningitis. He had immediate hypotension and bronchospasm after ceftriaxone previously, and Listeria risk is substantial. Which empirical allergy regimen is specifically suggested by NICE?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Use co-trimoxazole plus chloramphenicol after urgent infection-specialist advice

Explanation lettering: E = shown as A · A = shown as D · D = shown as E

A re-exposes a person with severe immediate cephalosporin allergy. B includes two beta-lactams despite severe allergy. C is not the NICE severe-allergy pathway and bypasses specialist input. D is correct: for severe allergy with Listeria risk, NICE suggests co-trimoxazole plus chloramphenicol and specialist advice. E does not reliably cover the likely meningitis pathogens.

Reference: NICE NG240: bacterial meningitis and meningococcal disease: https://www.nice.org.uk/guidance/ng240/chapter/Recommendations