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Bacterial meningitis — MCCQE Part 1 MCQ

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ModerateHeadacheBacterial meningitisMCCQE Part 1

A 20-year-old university student presents with fever, severe headache, photophobia, neck stiffness and a purpuric rash. He is confused and hypotensive. Which of the following is the most appropriate next step?

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

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Correct answer: B — Give empiric intravenous antibiotics immediately after blood cultures without delaying for lumbar puncture if unstable

Suspected bacterial meningitis with sepsis requires immediate empiric antibiotics; blood cultures should be obtained if this does not delay treatment. Lumbar puncture can follow when safe, but waiting in an unstable patient worsens outcomes. Antiviral-only or migraine management is unsafe in meningococcal features.

Reference: Association of Medical Microbiology and Infectious Disease Canada; provincial meningitis pathways