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Meningococcemia — MCCQE Part 1 MCQ

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HardRashMeningococcemiaMCCQE Part 1

A 7-year-old has fever, a rapidly spreading non-blanching rash, delayed capillary refill and reduced consciousness. The small rural clinic has no laboratory and IV access has not yet been obtained. Which action should occur now?

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

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Correct answer: D — Give IM ceftriaxone, start shock resuscitation and arrange transfer

Secure IV access and draw cultures prior to the first antibiotic dose: Cultures are desirable but must not delay treatment of a rapidly fatal infection. Give oral cefixime and reassess perfusion after the first dose: Oral absorption is unreliable in shock and oral cefixime is not definitive treatment for invasive disease. Transfer directly and give the first parenteral antibiotic on arrival: A forty-minute untreated transfer creates avoidable delay when parenteral antibiotic is available. Give dexamethasone pending rapid meningococcal molecular confirmation: Dexamethasone cannot replace antimicrobial and haemodynamic treatment. Give IM ceftriaxone, start shock resuscitation and arrange transfer: Immediate IM therapy provides active antibiotic exposure while vascular access, shock treatment and definitive paediatric transfer proceed.

Reference: https://cps.ca/en/documents/position/invasive-meningococcal-disease