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Listeria meningitis — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesListeria meningitisSCE Acute Medicine

A 51-year-old woman presents with fever, systemic upset and acute deterioration. Relevant history includes a plausible infectious exposure or immunocompromising context. On assessment, NEWS2 is elevated and there are features of organ dysfunction. Investigations show older immunosuppressed patient with meningitis and lymphocyte-predominant CSF. What is the most appropriate next step in management?

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

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Correct answer: D — Add intravenous amoxicillin to cover Listeria

The key discriminator is that older immunosuppressed patient with meningitis and lymphocyte-predominant CSF, which makes Add intravenous amoxicillin to cover Listeria the single best answer. Start anticoagulation after assessing bleeding risk is less appropriate because it does not address the dominant acute risk in the vignette; Arrange urgent CT imaging would fit a different presentation or later stage of care. Optimise chronic medication and discharge and Give targeted antidote or reversal therapy are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG240; BNF