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Influenza with secondary bacterial pneumonia — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesInfluenza with secondary bacterial pneumoniaSCE Acute Medicine

A 71-year-old man 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 biphasic flu illness followed by lobar consolidation and hypoxaemia. 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: E — Give antiviral therapy plus antibiotics covering bacterial pneumonia

The key discriminator is that biphasic flu illness followed by lobar consolidation and hypoxaemia, which makes Give antiviral therapy plus antibiotics covering bacterial pneumonia the single best answer. Arrange routine outpatient follow-up is less appropriate because it does not address the dominant acute risk in the vignette; Start anticoagulation after assessing bleeding risk would fit a different presentation or later stage of care. Provide supportive care and close monitoring and Arrange urgent CT imaging 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: UKHSA influenza guidance; NICE NG250