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Meningococcal Septicaemia — RACP Adult Medicine MCQ

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EasyEmergency MedicineMeningococcal SepticaemiaRACP Adult Medicine

A 42-year-old woman presents with acute severe headache, neck stiffness, and a petechial rash spreading rapidly. GCS is 13. She is febrile (40°C) and hypotensive. What is the single most important immediate action?

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Correct answer: C — IV ceftriaxone immediately without waiting for investigations

Suspected meningococcal septicaemia (petechial/purpuric rash + meningism + shock) is a medical emergency where minutes count. IV antibiotics (ceftriaxone 2 g) must be given IMMEDIATELY – before LP, before CT, before blood cultures are drawn if there will be any delay. The case fatality rate for meningococcal septicaemia increases significantly with each hour of delayed treatment. Blood cultures can be drawn simultaneously but must NOT delay antibiotic administration.

Reference: eTG – 2025 – Antibiotic Guidelines; CDNA – 2024 – Meningococcal Disease National Guidelines