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Acute bacterial meningitis — SCE Acute Medicine MCQ

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ModerateAcute Neurological PresentationsAcute bacterial meningitisSCE Acute Medicine

A 24-year-old woman is assessed on the acute medical unit. She has fever, headache, photophobia and a petechial rash. GCS is 14 and lumbar puncture will be delayed by thrombocytopenia. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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

Give broad-spectrum intravenous antibiotics within one hour is the best answer because suspected bacterial meningitis with rash requires immediate antibiotics rather than waiting for LP. Give activated charcoal within one hour 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: Dexamethasone is adjunctive, not a substitute for antibiotics.

Reference: NICE NG240