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Sepsis in asplenia after dog bite — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesSepsis in asplenia after dog biteSCE Acute Medicine

A 82-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 asplenia, dog bite and rapidly progressive shock. What is the most appropriate next step in management?

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Correct answer: D — Give urgent broad-spectrum intravenous antibiotics including Capnocytophaga cover

The key discriminator is that asplenia, dog bite and rapidly progressive shock, which makes Give urgent broad-spectrum intravenous antibiotics including Capnocytophaga cover the single best answer. Give intravenous fluids with reassessment is less appropriate because it does not address the dominant acute risk in the vignette; Optimise chronic medication and discharge would fit a different presentation or later stage of care. Give targeted antidote or reversal therapy and Call critical care for escalation 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: BSH asplenia guidance