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Meningococcemia — MCCQE Part 1 MCQ

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EasyRashMeningococcemiaMCCQE Part 1

A 6-year-old has fever, lethargy, leg pain and a non-blanching purpuric rash. Capillary refill is 5 seconds and blood pressure is low. Which of the following is the most appropriate next step?

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Correct answer: E — Immediate sepsis management with empiric parenteral antibiotics and resuscitation

Fever with purpura and shock is meningococcemia until proven otherwise and requires immediate antibiotics and resuscitation. Waiting for confirmation increases mortality. Urticaria is blanching and pruritic, not purpuric with poor perfusion.

Reference: Canadian Paediatric Society sepsis/meningococcal guidance; provincial paediatric sepsis pathways