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Bacterial meningitis — ABEM Board MCQ

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ModerateNeurological emergenciesBacterial meningitisABEM Board

A 24-year-old college student arrives with fever, severe headache, and photophobia. Triage acuity is ESI 2; T 103.0 F, BP 104/62 mm Hg, HR 122/min. He is confused and has nuchal rigidity with a petechial rash. There are no focal neurologic signs. Which of the following 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: A — Give empiric IV ceftriaxone and vancomycin immediately after blood cultures

Suspected bacterial meningitis requires rapid empiric antibiotics; lumbar puncture should not delay treatment when clinical suspicion is high.

Reference: IDSA bacterial meningitis guideline; CDC meningococcal disease guidance