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Meningococcal septicaemia — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesMeningococcal septicaemiaSCE Acute Medicine

A 19-year-old man is assessed on the acute medical unit. He has fever, myalgia, confusion and a rapidly spreading non-blanching rash. Blood pressure is 86/42 mmHg and capillary refill is prolonged. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most important immediate action?

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Correct answer: E — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because meningococcal sepsis is immediately life-threatening and requires prompt parenteral antibiotics and resuscitation. Give intravenous calcium gluconate with cardiac monitoring is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: A non-blanching rash with shock should be treated as meningococcal disease until proven otherwise.

Reference: NICE NG240; NICE NG253