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Bacterial meningitis — SCE Acute Medicine MCQ

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ModerateSepsis and Infectious EmergenciesBacterial meningitisSCE Acute Medicine

A 42-year-old woman is assessed on the acute medical unit. She has fever, headache, photophobia and neck stiffness. GCS is 13 and CT head is being arranged because of a focal cranial nerve palsy. 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: B — Give broad-spectrum intravenous antibiotics within one hour

Give broad-spectrum intravenous antibiotics within one hour is the best answer because suspected bacterial meningitis should receive immediate antibiotics if lumbar puncture is delayed for imaging. Start non-invasive ventilation on the acute unit 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: Do not let imaging delay antibiotics in suspected meningitis.

Reference: NICE NG240